Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 8115
© 2004 American Society of Clinical Oncology

Clinical predictors of severe fatigue in solid tumor patients seeking acute care

R. Valdres, E. Manzullo and C. P. Escalante

U Texas M. D. Anderson Cancer Center, Houston, TX

Background: Fatigue is the most common symptom of cancer patients and has been described in various populations. Our objectives are to describe solid tumor patients (STP) and clinical factors associated with severe fatigue (defined as worst fatigue in past 24 hours 7/10) in an acute care setting and to determine whether certain clinical factors available during the emergency center (EC) visit identify patients with severe fatigue.

Methods: A retrospective cohort of 653 STP admitted to the EC from 5/1/01 to 8/15/01 was studied. Data abstracted from the medical record included demographic, clinical and cancer treatment factors. Descriptive statistics, chi-square and "student" t-tests were utilized. In developing a preliminary predictive model, stepwise logistic regression was employed.

Results: The mean age was 56 years (range, 19–92); 333 (51%) were female. The most frequent malignancies were breast cancer 119 (18%) and lung cancer 98 (15%). The majority, 345 (53%) had controlled disease. Of the cohort, 277 (58%) had Zubrod performance scores 2. Half (326) were not currently receiving cancer treatment. Fifty-seven percent (372) had severe fatigue and over half (51%) had both severe fatigue and severe pain. (Table 1)  

Conclusions: A majority of STP seeking acute care has severe fatigue. This preliminary model identifies clinical factors in STP with severe fatigue in our EC. Model validation is necessary. If validated, some patients may benefit from earlier identification and referral for fatigue management strategies. This may improve their overall quality of life and potentially influence a lower care level with less cost.