General Condition Of Patient Research Articles

Differentiated approach to the minimally invasive management of malignant obstructive jaundice

Attitude towards preoperative biliary drainage for malignant obstructive jaundice have recently changed twice. This is due certain factors including complications of minimally invasive biliary drainage, level of bile duct block, cholangitis, need for neoadjuvant chemotherapy, time to scheduled surgery, severe general condition of patient, future liver remnant volume. We comprehensively searched PUBMED, MD Consult and National Library of Medicine using the following keywords: “obstructive jaundice (OJ)”, “cellular immunity”, “preoperative biliary drainage”, “selective biliary drainage”, “distal and proximal bile duct block”, “complications”. Randomized clinical trials and meta-analyzes, opinions of reputable specialists in hepatopancreatobiliary surgery and our own experimental and clinical studies were foreground. The analysis showed that preoperative biliary drainage is not a safe procedure and results an increased number of complications. Absolute indications for preoperative biliary drainage are cholangitis, need for neoadjuvant chemotherapy, increased risk of radical surgery and unresectable tumor. Future liver remnant volume should be considered in patients with portal cholangiocarcinoma followed by proximal block to determine indications for preoperative biliary drainage.

Antibiotic therapy in Endodontics: a survey from dental surgeons in Ivory Coast

Aim: The objective of this study was to evaluate the antibiotics prescription in endodontics. Methodology: This was a descriptive cross-sectional survey, type KAP (Knowledge, Attitudes and Practices) of 111 dental surgeons in Abidjan (Ivory Coast). Results: 11.70% of practitioners routinely prescribe antibiotics for endodontic treatment; 64.90% prescribes them for Acute Apical Periodontitis, 57.70% for Pulp Necrosis and 52.30% for Abscess. According to the patient general condition, practitioners prescribe antibiotics for general illness (89.20%) or poor hygiene (55%). Βeta-lactam antibiotics are prescribed in 98.20% of cases. For 96.4% of practitioners, antibiotic therapy influences an endodontics success; 19.80% do not know about prescription recommendations; 37.80% have received antibiotics self-medicated patients. Conclusions: In Ivory Coast, the antibiotics prescription in endodontics does not always adhere to international recommendations. The anarchic consumption of these drugs is mostly due to self-medication.

Incidence of Surgical Emergencies – A Hospital Based Study in Ranga Reddy District of Telangana

Background: Surgical emergencies are unique group of cases which require quick decisions and these decisions have significant effect on outcome. Most of these surgeries performed in emergency situations where the value of the exhaustive investigations has to be balanced against any deterioration which may occur in patient's general condition due to inevitable delay. Objective: The objective of this study was to identify the spectrum of surgical emergencies and their outcome. Design: This was a hospital based prospective analysis of surgical emergencies presented to Unit I and V of General Surgery Department, Bhaskar General Hospital. Duration: Surgical emergencies over a period of three years from 2015 to 2017 were analyzed to identify the spectrum of surgical emergencies and their outcome. Setting: Department of Pediatrics, Bhaskar Medical College, Yenkapally, Moinabad, Ranga Reddy District, Telangana, India. Participants: A total of 2372 patients who underwent emergency surgery in Unit I and  Unit V of General Surgery Department, Bhaskar General Hospital. Subjects and Methods: A retrospective analysis of the reports of all the patients who were operated upon was performed to assess the spectrum of surgical emergencies and their outcome. Data was tabulated using MS Excel and statistical analysis was performed using appropriate statistical software. Results: Among Non-trauma cases, 51.24% (472) were Appendicitis (i.e., 19.95% of total cases), 34.90% (322) were of Intestinal obstruction, 12.03% (114) were hollowviscus perforations and others include 0.71% (56) of  cases . Most of the surgeries were performed under spinal anaesthesia. A few cases were performed under General anaesthesia. Among trauma cases, 85.16% (1234) of them were minor injuries that required conservative management or minor surgeries & 14.84% (215) of them were managed with major surgery. Conclusion: Among non-trauma cases, most of the cases were of intestinal obstruction and most of the surgeries were performed under spinal anaesthesia. Among trauma cases, most of them were minor injuries that required conservative management or minor surgeries and few of them were managed with major surgery.

The impact of deep vein thrombosis prevention training on patients′ knowledge and self-management

Objective To investigate the effect of nurse-directed prevention of deep vein thrombosis (DVT) on deep vein thrombosis knowledge and self-management. Methods From April 2016 to April 2017, patients who underwent surgery in the Department of Thoracic Surgery, Urology, and General Surgery of Nanyang Central Hospital were divided into study group and control group. 80 patients in each group were included in the study. Patients in the study group were trained in DVT prevention, and the control group received routine nursing measures. The general condition of the patients was recorded, and the differences between the general conditions of the two groups and the DVT prevention questionnaire scores and the completion rate of self-care practice after DVT were compared. Results The scores of the DVT prevention questionnaires in the study group were significantly higher than those in the control group (U=-4.83--2.04, P < 0.05). The scores of the DVT prevention questionnaires of the study group aged 19-51 were significantly higher than those of the 52-82-year-old patients (U=63.7, P<0.05). The DVT prevention questionnaires of the highly educated patients were lower than those with low education. The DVT prevention questionnaire score was significantly increased (χ2=12.54, P<0.05). In the comparison of 13 self-care practices between the study group and the control group, the patient had bedside activities, raised the legs beyond the heart level, timed over, deep breathing exercises, foot exercises, leg exercises, standing, wearing antithrombotic socks, measuring the legs Surround, measure the pulse of the foot, check the leg, check the amount of self-liquid intake, and understand the completion rate of self-coagulation treatment (χ2=6.76-91.17, P < 0.05). Conclusion Through training, patients′ awareness of DVT is improved, and the ability of self-training to prevent postoperative DVT is improved. Key words: Deep vein thrombosis; Risk; Practice; Self-care

Treatment options for advanced laryngeal carcinoma

Laryngeal cancer is one of the most common malignancies in the head and neck. With the development in clinical research of multimodality therapy for recent years, the treatment strategies for laryngeal cancer, especially for advanced cases, have changed significantly. The management for laryngeal cancer needs the adequate assessments of the primary tumor and the general condition of patient, the comprehensive application of multiple treatment modalities including surgery, radiation, chemotherapy and biotherapy, and the design of individualized regimens. The goal is to eradicate the tumor completely with maximal reconstruction and preservation of laryngeal functions, and to improve patient's quality of life without reduction in survival rate.

The role of external osteosynthesis in treatment of unstable pelvic osseous injuries

Objective. To specify the role and indications for application of аpparatus of external fixation (АEF) in treatment of unstable pelvic osseous injuries (UPOI); to study up the advantages and faults of the external fixation method; to share the experience of treatment, using this procedure.&#x0D; Маterials and methods. There were 229 patients, suffering pelvic injuries, examined on the base of orthopedic-traumatological centre of Kyiv’s Regional Clinical Hospital in 2005 - 2017 yrs and distributed into three Groups. In Group I 143 (62.4%) injured persons were included, in whom external osteosynthesis played the function of temporary measures of fixation, in Group II - 27 (11.8%) patients, in whom while hospitalization a fracture was fixed, using AEF, аnd after stabilization of the state the posterior pelvis osteosynthesis and reposition was conducted, in Group III - 59 (25.8%) patients, who, using several indications, were definitely treated, applying the external fixation method only.&#x0D; Results. Excellent effect of treatment in Group I was registered in 23 (19.0%), a good one - in 58 (47.9%), satisfactory - in 32 (26.4%), poor - in 8 (6.6%) of 121 patients; in Group II - accordingly, - in 5 (20.8%), 11 (45.8%), 7 (29.2%) and 1 (4.2%) of 24 patients; in Group III - accordingly, in 4 (8.3%), 12 (25%), 23 (47.9%) and 9 (18.6%) of 48 patients.&#x0D; Conclusion. Best results of treatment of patients with unstable pelvic osseous injuries were obtained while applying the tactics of change from external fixation into internal one. On the first stage the pelvic ring fixation, using AEF, was performed, аnd after stabilization of a patient general status - internal osteosynthesis. Application of the internal osteosynthesis method permits to control and stabilize the reposition achieved, to conduct the sacro-ileal joint revision.

Tu1714 – Impact of Upadacitinib on the General Clinical Condition of Patients with Crohn's Disease (CD): Data from the Randomised Celest Study

Tu1714 – Impact of Upadacitinib on the General Clinical Condition of Patients with Crohn's Disease (CD): Data from the Randomised Celest Study

Correlation between the complexity of patients undergoing total hip arthroplasty and the actual perceived workload of nurses

Objective To investigate the relationship between the complexity of patients undergoing total hip arthroplasty and the actual workload of nurses. Methods This study was a retrospective cohort study. A total of 45 patients were randomly selected from March 2016to March 2017to undergo hip arthroplasty at the hospital orthopedic department. The general condition of each patient at the time of admission was recorded, using ASA, CCI and The Katz-ADL scale score evaluates the complexity of the patient's surgery. Actual nursing workload was recorded on the first postoperative day. Use the self-developed questionnaires in the department to assess the workload actually felt by nurses. The correlations between the above scores, BMI and actual workload scores and actual perceived workload were analyzed. Results There was no statistically significant correlation between the actual workload of nurses and patient complexity. There was a statistically significant correlation between ASA (tau_b=0.73, P <0.01) and CCI (Rho = 0.64; P<0.01) and nurses' actual perceived workload. Conclusions Orthopedic nurses have greater self-induction work pressure for the patients undergoing total hip arthroplasty. Key words: Total hip arthroplasty; Complications; Workload; ASA classification; Nurses

Complications and outcome of percutaneous endoscopic gastrostomy in a high-volume centre

Introduction: Percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term enteral feeding for patients with swallowing disorders and normal gut function. There is limited data regarding the demographics and clinical characteristics of patients from whom PEG was removed.Patients and methods: We performed a retrospective analysis of all consecutive adult patients who underwent first placement of PEG between 1 August 2013 and 31 December 2015 at Karolinska University Hospital in Stockholm, Sweden.Results: In total, 495 PEG were inserted in 495 patients during the study period, 56% male, mean age at insertion 67 years (range 19–95). Most patients belonged to the neurologic group (52%), followed by the oncologic (32%), another diagnosis (9%) and trauma (7%). Major complications occurred in 10 (2.0%) patients. There were no differences in the age or BMI of patients with either minor or major complications but both parameters were risk factors in terms of survival. PEG was removed from 165 (33.3%) patients, most of them from the oncology group, due to the improvement of general status of patients after specific oncologic treatment.Conclusion: Increased age and low BMI were identified as risk factors for mortality but did not correspond with the rate of complications. Antibiotic prophylaxis with sulfamethoxazole and trimethoprim provides good protection for patients with PEG.

OPTIONS FOR SURGICAL TREATMENT OF CHRONIC C2 ODONTOID FRACTURES

The paper presents a review of three clinical cases of treating patients with chronic fractures of the odontoid process of C2 vertebra using various combinations of surgical techniques. In all cases, complete decompression of the spinal cord and stabilization of the upper cervical segment of the spine were achieved. A decrease in the range of motion in the cervical spine was observed, which did not affect patient satisfaction. A gradual regression of the neurological status and increase in muscle strength were recorded. Comparative analysis of the neurological status was carried out before and after surgical treatment. When assessing the general condition of patients using the index of disability due to pain in the neck (NDI), an improvement in the quality of life was noted. These data show the opportunities and peculiarities of methods for treating patients with chronic C2 odontoid fractures.Type of publication: description of clinical cases. Evidence level: IV.

Expression of matrix metalloproteinase-3 in patients with reheumatoid arthritis and its correlation with chronic periodontitis and rheumatoid arthritis

Objective: To detect the expression of matrix metalloproteinase-3 (MMP-3) in serum and gingival crevicular fluid in patients with rheumatoid arthritis (RA) and its correlation with chronic periodontitis (CP). Methods: From March 2017 to July 2018, 26 patients with RA and CP [CP+RA group, (54.9±6.5) years old, 4 males and 22 females], 22 patients with RA only [RA group, (49.6±11.7) years old,5 males and 17 females] in the Department of Rheumatology and Immunology, Shengjing Hospital Affiliated to China Medical University, 22 patients with simple CP in the Department of Stomatology, Shengjing Hospital Affiliated to China Medical University [CP group, (51.4±12.5) years old, 8 males and 14 females] and 18 generally healthy controls in Physical Examination Center of Shengjing Hospital Affiliated to China Medical University [group H, (49.4±9.1) years old, 8 males and 10 females] were recruited. There were no significant differences in age and sex ratio amongst 4 groups. Patient's general status, probing depth (PD) , clinical attachment loss (CAL), sulcus bleeding index (SBI), simplified calculus index (CI-S) and simplified debris index (DI-S) were recorded in 4 groups. Samples of serum and gingival crevicular fluid were collected from patients of each group, and the expression levels of MMP-3 in serum and gingival crevicular fluid samples were detected by using enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate, rheumatoid factor, anti-cyclic citrulline peptide antibody and C-reactive protein were detected in the serum of subjects in RA group and CP+RA group. Correlation analysis was conducted between MMP-3 expression level and periodontal indices amongst 4 groups. The results were statistically analyzed using the SPSS 20.0 software package. Results: The indices of CAL [(4.12±1.13) mm], SBI (2.58±0.64) and DI-S (2.65±0.69) in CP+RA group were significantly higher than indices of CAL [(3.00±0.00) mm], SBI (2.59±1.05) and DI-S, (2.36±0.49) in CP group (P<0.05); The expression levels of MMP-3 in serum samples of CP+RA group [(1 1645.6±6 903.4) μg/L] and CP group [(9 337.0±6 719.0) μg/L] were significantly higher than that of RA group [(2 389.9±1 320.3) μg/L] and H group [(1 493.5±292.1) μg/L] (P<0.05). The expression level of MMP-3 in gingival crevicular fluid samples of CP+RA group [(164.4±45.3) μg/L] was significantly higher than that of CP group [(84.6±92.5) μg/L], RA group [(49.0±18.1) μg/L] and H group [(20.4±6.3) μg/L] (P<0.05), respectively. The erythrocyte sedimentation rate, rheumatoid factor and anti-cyclic cirullinated peptide antibodies levels in the CP+RA group were significantly higher than those in the RA group (P<0.05). The expression level of MMP-3 in serum is positively correlated with PD (r=0.45, P=0.04) and the expression level of MMP-3 in gingival crevicular fluid is positively correlated with CAL (r=0.58, P<0.01). Conclusions: The levels of MMP-3 in serum and gingival crevicular fluid of patients with RA and CP were significantly increased. MMP-3 may be associated with the development of CP and RA.

Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients-Substantial Changes in 2003⁻2017.

Introduction: The objective of the analysis was to determine the epidemiology of healthcare-associated infections (HAIs) in neurosurgical patients, paying special attention to two time points, 2003 and 2017, in order to evaluate the effectiveness of a surveillance program introduced in 2003 and efforts to reduce infection rates. Materials and methods: Continuous surveillance during 2003–2017 carried out using the HAI-Net methodology allowed us to detect 476 cases of HAIs among 10,332 patients staying in a 42-bed neurosurgery unit. The intervention in this before–after study (2003–2017) comprised standardized HAI surveillance with regular analysis and feedback. Results: The HAI incidence during the whole study was 4.6%. Surgical site infections (SSIs) accounted for 33% of all HAIs with an incidence rate of 1.5%. The remaining infections were pneumonia (1.1%) and bloodstream infections (0.9%). The highest SSI incidence concerned spinal fusion (FUSN, 2.2%), craniotomy (1.9%), and ventricular shunt (5.1%) while the associated total HAI incidence rates were 4.1%, 8.0%, and 18.6%, respectively. A significant reduction was found in HAI incidence between 2003 and 2017 in regard to the most common surgery types: laminectomy (4.5% vs. 0.8%); FUSN (11.8% vs. 0.8%); and craniotomy (10.1% vs. 0.4%). Significant changes were also achieved in selected elements of the unit’s work: pre-hospitalization duration, hospital stay, and surgery length reductions. Simultaneously, the general condition of patients became significantly worse: there was an increase in patients’ age and decreases in their general condition as expressed by ASA scores (The American Society of Anesthesiologists physical status classification system). Conclusions: HAI epidemiology changed substantially during the study period. Among the main types of HAI, SSIs were slightly predominant, but non-surgical HAIs accounted for almost two thirds of all infections; this indicates the need for surveillance of infection types other than SSIs in surgical patients. The implementation of active surveillance based on regular analysis and feedback led to a significant reduction in HAI incidence.

Importance of medical data preprocessing in predictive modeling and risk factor discovery for the frailty syndrome

BackgroundIncreasing life expectancy results in more elderly people struggling with age related diseases and functional conditions. This poses huge challenges towards establishing new approaches for maintaining health at a higher age. An important aspect for age related deterioration of the general patient condition is frailty. The frailty syndrome is associated with a high risk for falls, hospitalization, disability, and finally increased mortality. Using predictive data mining enables the discovery of potential risk factors and can be used as clinical decision support system, which provides the medical doctor with information on the probable clinical patient outcome. This enables the professional to react promptly and to avert likely adverse events in advance.MethodsMedical data of 474 study participants containing 284 health related parameters, including questionnaire answers, blood parameters and vital parameters from the Toledo Study for Healthy Aging (TSHA) was used. Binary classification models were built in order to distinguish between frail and non-frail study subjects.ResultsUsing the available TSHA data and the discovered potential predictors, it was possible to design, develop and evaluate a variety of different predictive models for the frailty syndrome. The best performing model was the support vector machine (SVM, 78.31%). Moreover, a methodology was developed, making it possible to explore and to use incomplete medical data and further identify potential predictors and enable interpretability.ConclusionsThis work demonstrates that it is feasible to use incomplete, imbalanced medical data for the development of a predictive model for the frailty syndrome. Moreover, potential predictive factors have been discovered, which were clinically approved by the clinicians. Future work will improve prediction accuracy, especially with regard to separating the group of frail patients into frail and pre-frail ones and analyze the differences among them.

Effects of Physical Rehabilitation in Patients with Spinocerebellar Ataxia Type 7.

Today, neurorehabilitation has become in a widely used therapeutic approach in spinocerebellar ataxias; however, there are scarce powerful clinical studies supporting this notion, and these studies require extension to other specific SCA subtypes in order to be able to form conclusions concerning its beneficial effects. Therefore, in this study, we perform for the first time a case-control pilot randomized, single-blinded, cross-sectional, and observational study to evaluate the effects of physical neurorehabilitation on the clinical and biochemical features of patients with spinocerebellar ataxia type 7 (SCA7) in 18 patients diagnosed with SCA7. In agreement with the exercise regimen, the participants were assigned to groups as follows: (a) the intensive training group, (b) the moderate training group, and (c) the non-training group (control group).We found that both moderate and intensive training groups showed a reduction in SARA scores but not INAS scores, compared with the control group (p < 0.05). Furthermore, trained patients exhibited improvement in the SARA sub-scores in stance, gait, dysarthria, dysmetria, and tremor, as compared with the control group (p < 0.05). No significant improvements were found in daily living activities, as revealed by Barthel and Lawton scales (p > 0.05). Patients under physical training exhibited significantly decreased levels in lipid-damage biomarkers and malondialdehyde, as well as a significant increase in the activity of the antioxidant enzyme PON-1, compared with the control group (p < 0.05). Physical exercise improved some cerebellar characteristics and the oxidative state of patients with SCA7, which suggest a beneficial effect on the general health condition of patients.

P313 Impact of upadacitinib on the general clinical condition of patients with Crohn’s disease (CD): data from the randomised CELEST study

P313 Impact of upadacitinib on the general clinical condition of patients with Crohn’s disease (CD): data from the randomised CELEST study

Low Phase Angle Is Correlated With Worse General Condition in Patients with Advanced Cancer

Objectives: Phase angle (PA) is a poor prognostic factor in patients with advanced cancer. This study aimed to identify possible correlations between PA and symptoms, quality of life, fluid retention, and laboratory data in cancer patients in palliative care settings.Methods: Individuals who visited the outpatient clinic or were admitted to the palliative care unit were eligible. Patients with a performance status of 4 and/or those unable to complete questionnaires were excluded. PA was evaluated using a bioanalyzer device. The correlation coefficient between PA and the variables of interest was analyzed.Results: A total of 102 patients were analyzed. PA was weakly correlated with age (ρ = −0.22), performance status (ρ = −0.30), functional well-being (ρ = 0.20), anorexia/cachexia subscale (ρ = 0.22), and Functional Assessment of Anorexia/Cachexia Therapy trial outcome index (ρ = 0.26). PA was also correlated with fluid retention (ρ = −0.34) and albumin (ρ = 0.32), C-reactive protein (ρ = −0.31), and hemoglobin (ρ = 0.41) levels. Sub-analysis stratified according to sex revealed that males demonstrated the same results; however, female sex demonstrated a correlation between PA and social well-being (ρ = −0.43).Conclusions: PA was correlated with physical condition, but not with psychological well-being.

The nurses’ own views about the inter-shift handover process

Background: Nursing handovers provide critical information on the patient, requiring special communication skills and techniques between the nurses’ shift-change.Aim: Current study investigates the experiences/views of nurses regarding the handover process.Methods: An observation method was applied assesing 22 interviews using a semi-structured questionnaire and an audio recording system throughout mixed content analysis.Results: Nursing handover mainly involves medical instructions, detailed records of each patient's general condition or drug administration guidelines. Nurses determined which pieces of information were significant to transfer to the next shift were the medical instructions, the patient's hemodynamic condition and the care plans implemented by the previous nurse. The information was mainly drawn from events occurring in the previous 24 h, from the medical instructions, or the doctors and the nursing outcomes, and to a lesser extent from the events of the previous shifts and the nursing folders. None of the participants had received, as they stated, any training in the handover process.Conclusions: It is highlighting the importance of organized, standardized and up-to-date handovers, and the fundamental part they play in the health care system.

Acute hemorrhagic edema of infancy

In infants less than 2 years of age, acute hemorrhagic edema of infancy (AHEI) is characterized by the rapid onset of annular purpuric lesions associated with initially localized edemas affecting the extremities. This disorder is usually benign, without visceral involvement. Diagnosis is based on clinical examination, no specific laboratory findings exist and the histological examination of the lesions (which is unnecessary in the majority of cases) is most often nonspecific (sometimes patients have nonspecific leukocytoclastic vasculitis). Nosological status of AHEI remains unclear, but some reports suggest it is a clinical manifestation of rheumatoid purpura. Rhinopharyngeal episodes in the days before its onset have sometimes been reported, suggesting a viral cause. There is a net mismatch between patient's good general condition and the remarkable dissemination of the lesions. Infants monitoring must be rigorous in the first days, even though complications are exceptional (acute intussusception). Patients recover spontaneously within 12 days. Therapeutic management is based on accurate monitoring of the infant's general status. Fever, the extension of the purpuric lesions and, in particular, signs of impaired general condition may suggest the diagnosis of purpura fulminans. Another differential diagnosis is acute hemorrhagic or ecchymotic urticaria. We here report the case of a 3-month old infant with diffuse pseudoannular lesions within a context of apyrexy and preservation of patient's general condition. Patient's outcome was favorable without any treatment, confirming the diagnosis of AHEI.

Stroke and depression

Depression is a frequent complication of stroke and occurs in approximately one in three surviving patients. Depression worsens the course of post-stroke neurological disorders, enhances the physical helplessness of patients, further reduces their quality of life, significantly decreases the effectiveness of therapeutic and rehabilitation measures and increases the risk of death. Antidepressants eliminate or relieve depressive symptoms, mitigate neurological disorders, improve cognitive functions and the general condition of patients, increase the effectiveness of treatment and rehabilitation, diminish the risk of recurrent stroke and decrease mortality. Selective serotonin reuptake inhibitors are the first line antidepressants for post-stroke patients; there is evidence of the effectiveness of other modern antidepressants, as well as tricyclic drugs. Unresolved aspects of this problem that require further well-designed controlled studies include tolerability of antidepressants by patients of late age, the choice of optimal drugs and the duration of therapy.

Assesment of symptom burden and related factors of patients with lung cancer in a palliative care unit

INTRODUCTION AND AIM: Symptom palliation is important in terms of improving quality of life and therapy compliance in patients diagnosed with lung cancer. In this study, we intend to describe the tumor symptoms and related factors with Edmonton Symptom Assessment Scale (ESAS) in patients who admitted to a palliative care unit. MATERIALS AND METHODS: Two hundred and ninety patients with lung cancer who admitted to our tertiary outpatient palliative clinic were retrospectively reviewed. Pathological diagnosis, stage, demographic features, comorbidities, treatment modalities, and ESAS score were recorded. Survival was analyzed using Kaplan–Meier analysis. RESULTS: There was no relation between stage of disease and ESAS score. The mean sleep variance score was significantly higher in Stage IV patients compared to all other groups (P = 0.038). The scores of cough and how they felt themselves were significantly higher in patients with metastatic lymph node (n = 30; P = 0.016 and P = 0.027, respectively). The presence of diabetes mellitus was found to be significantly related to higher sadness and anxiety score (P = 0.046 and P = 0.023, respectively). Treatment modalities (Group 1: best supportive care [n = 22] and Group 2: others [n = 268]) did not affect the mean ESAS score (P > 0.05). The overall survival and mean ESAS score were not related (P > 0.05). CONCLUSION: ESAS contributes significantly to improve general medical condition of patients with lung cancer. Comorbidities should be considered along with ESAS during cancer management. Symptom score evaluation and proper palliative treatment is important in lung cancer patients. Anyway, the treatment period of lung cancer is already difficult enough, so physicians should facilitate this process for patients.