title: Fatigue and functional impairment in early-stage non-small cell lung cancer survivors.
abstract: BACKGROUND
  Fatigue is the most common sequela among non-small cell lung cancer (NSCLC) survivors one to six years post-treatment and is associated with functional limitations.
  
  
  OBJECTIVE
  This study examined the prevalence, severity, and correlates of fatigue among early stage NSCLC survivors.
  
  
  METHODS
  Three-hundred fifty individuals diagnosed and surgically treated for Stage IA or IB NSCLC completed a survey that included the Brief Fatigue Inventory (BFI) to assess the prevalence and severity of fatigue. The Karnofsky Self-Reported Performance Rating scale (SR-KPS) was used as a measure of functional status and was compared with the severity of fatigue through Chi-squared analyses. Demographic, psychological, and medical correlates of fatigue were examined using logistic regression.
  
  
  RESULTS
  The prevalence of fatigue was 57%. Forty-one percent (n=142) of participants had mild fatigue and 16.8% (n=59) had moderate or severe fatigue (BFI≥4). Among the individuals reporting moderate or severe fatigue, 23.7% (n=14) had significant functional impairment (SR-KPS≤70%) compared with 2.8% (n=8) with mild or no fatigue (χ(2)=58.1, P<0.001). In the multivariate analysis, NSCLC survivors with pulmonary disease (odds ratio [OR]=2.28), depressive symptoms (OR=6.99), and anxiety symptoms (OR=2.31) were more likely to report experiencing clinically significant fatigue, whereas those who met physical activity guidelines (OR=0.29) reported less fatigue.
  
  
  CONCLUSIONS
  Fatigue is highly prevalent among NSCLC survivors and associated with more functional impairment. A comprehensive approach to the treatment of fatigue includes the screening and management of anxious and depressive symptoms, and pulmonary disorders such as chronic obstructive pulmonary disease.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. robert.hung@sanfordhealth.org
authors.forename: Robert
authors.initials: R
authors.lastname: Hung
authors.forename: Paul
authors.initials: P
authors.lastname: Krebs
authors.forename: Elliot J
authors.initials: EJ
authors.lastname: Coups
authors.forename: Marc B
authors.initials: MB
authors.lastname: Feinstein
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Park
authors.forename: Jack
authors.initials: J
authors.lastname: Burkhalter
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Ostroff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000523:psychology; D016009:Chi-Square Distribution; D016208:Databases, Factual; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012720:Severity of Illness Index; D017741:Survivors / Q000706:statistics & numerical data*