Influence of social isolation and loneliness on the prognosis of advanced lung cancer patients: a prospective cohort study

Abstract

The purpose of this study was to investigate the impact of social isolation and loneliness on the overall survival and death at home in patients with lung cancer. MethodsThis prospective cohort study was conducted in a Japanese tertiary hospital. The enrollment period was from April 2018 to March 2020.Patients with pathologically diagnosed advanced lung cancer were included in this study. The primary outcome was overall survival, whereas the secondary outcome was death at home. The exposures were social isolation and loneliness. ResultsA total of 211 patients were enrolled and divided into two groups and further into quartiles according to their social isolation and loneliness level, respectively. The hazard ratios of social isolation were 1.65 (95% con dence interval; 1.12 to 2.44) and 1.87 (95% con dence interval; 1.15 to 3.03) in the univariate analysis, while 1.40 (95% con dence interval; 0.92 to 2.13) in the multivariate analysis with complete case and multiple imputation. The odds ratio of death at home with social isolation was 3.47 (95% con dence interval; 1.08 to 11.1) in the multivariate analysis with multiple imputation. Loneliness was not associated with overall survival or death at home. ConclusionsOur study suggests that social isolation may be related to overall survival and death at home among patients with advanced lung cancer. More attention should be given to such patients at the time of diagnosis.

Social isolation and loneliness: Undervalued risk factors for disease states and mortality

“…• Mobility limitation is an important risk factor for these conditions Takemura et al 97 • Social isolation is significantly related to death at home (OR 3.47, 95% CI 1.08-11.1) in the multivariate analysis with multiple imputation, but loneliness is not in association to overall survival or home mortality Koh-Bell et al 98 • This study is not able to identify an association between social isolation and cancer mortality (p = .54)…”

“…T A B L E 1 (Continued) wasn't. 97 In contrast, a study by Koh-Bell et al failed to confirm such an association. 98 Generally, studies suggest that social isolation can result in decreased therapeutic compliance, negative health conditions and mental health status, and a poor quality of life.…”

“…In a study including 211 patients with advanced lung cancer, Takemura et al reported that social isolation was independently related to death at home, but loneliness wasn't 97 . In contrast, a study by Koh‐Bell et al failed to confirm such an association 98 .…”