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. 2023 Mar;65(3):242-255.
doi: 10.1016/j.jpainsymman.2022.11.010. Epub 2022 Nov 21.

Distinct Shortness of Breath Profiles in Oncology Outpatients Undergoing Chemotherapy

Joosun Shin  1 , Kord M Kober  1 , Melisa L Wong  2 , Patsy Yates  3 , Bruce A Cooper  1 , Steven M Paul  1 , Marilyn Hammer  4 , Yvette Conley  5 , Jon D Levine  2 , Christine Miaskowski  6
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Distinct Shortness of Breath Profiles in Oncology Outpatients Undergoing Chemotherapy

Joosun Shin et al. J Pain Symptom Manage. 2023 Mar.

Abstract

Context: Shortness of breath is a distressing symptom that occurs in 10% to 70% of oncology patients. Despite this broad range in its occurrence, little is known about inter-individual variability in shortness of breath and associated risk factors among patients receiving chemotherapy.

Objectives: Identify subgroups of patients with distinct shortness of breath profiles; evaluate for differences among these subgroups in demographic and clinical characteristics; evaluate for differences among symptom dimensions of shortness of breath, and evaluate for differences in quality of life outcomes.

Methods: Outpatients (n=1338) completed questionnaires six times over two chemotherapy cycles. Occurrence of shortness of breath was assessed using the Memorial Symptom Assessment Scale. Latent class analysis was used to identify subgroups of patients with distinct shortness of breath profiles.

Results: Four distinct shortness of breath profiles were identified (None [70.5%], Decreasing [8.2%], Increasing [7.8%], High [13.5%]). Risk factors for membership in High class included: history of smoking, self-reported diagnosis of lung disease, having lung cancer, and receipt of a higher number of cancer treatments. Compared to the None class, High class reported poorer physical, psychological, and social functioning.

Conclusions: Almost 14% of patients with heterogeneous types of cancer receiving chemotherapy had persistently high occurrence rates of shortness of breath for almost two months. In addition, compared to the Decreasing and Increasing classes, the High class' episodes of shortness of breath were more frequent and more severe. Clinicians need to assess all oncology patients for shortness of breath and provide targeted interventions.

Keywords: Cancer; cough; dyspnea; latent class analysis; patient-reported outcomes; quality of life.

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Figures

Fig. 1.
Fig. 1.
Trajectories of shortness of breath occurrence for the four latent classes.
Fig. 2.
Fig. 2.
Percentages of patients in the decreasing, increasing, and high classes who rated the frequency (a), severity (b), and distress (c) associated with shortness of breath.
See this image and copyright information in PMC

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