Risk prediction and impaired tactile sensory perception among cancer patients during chemotherapy 1

Cardoso, Ana Carolina Lima Ramos; Araújo, Diego Dias de; Chianca, Tânia Couto Machado

doi:10.1590/1518-8345.1979.2957

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 25 • 2017 • https://doi.org/10.1590/1518-8345.1979.2957 copy

Risk prediction and impaired tactile sensory perception among cancer patients during chemotherapy ¹ 1 Paper extracted from Master’s Thesis “Percepção sensorial tátil perturbada em pacientes oncológicos sob quimioterapia: análise da literatura e validação clínica”, presented at Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to estimate the prevalence of impaired tactile sensory perception, identify risk factors, and establish a risk prediction model among adult patients receiving antineoplastic chemotherapy.

Method:

historical cohort study based on information obtained from the medical files of 127 patients cared for in the cancer unit of a private hospital in a city in Minas Gerais, Brazil. Data were analyzed using descriptive and bivariate statistics, with survival and multivariate analysis by Cox regression.

Results:

57% of the 127 patients included in the study developed impaired tactile sensory perception. The independent variables that caused significant impact, together with time elapsed from the beginning of treatment up to the onset of the condition, were: bone, hepatic and regional lymph node metastases; alcoholism; palliative chemotherapy; and discomfort in lower limbs.

Conclusion:

impaired tactile sensory perception was common among adult patients during chemotherapy, indicating the need to implement interventions designed for early identification and treatment of this condition.

Descriptors:
Neoplasms; Drug Therapy; Neurotoxicity Syndromes; Touch Perception; Nursing Diagnosis

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Ana Carolina Lima Ramos Cardoso Hospital Unimed Vale do Aço Rua Ipanema, 86 Centro CEP: 35170-032, Coronel Fabriciano, MG, Brasil E-mail: enf.anacardoso@gmail.com

Variables	Impaired tactile sensory perception						HR*[CI 95%^†]	p^‡
	Yes		No		Total
	n	%	n	%	n	%
Hepatic metastasis	4	5	1	2	5	4	5.26 [1.85-14.9]	0.002
Palliative chemotherapy	35	48	42	78	77	61	0.52 [0.32-0.83]	0.007
Phlebitis	6	11	14	19	20	16	2.05 [1.12-3.75]	0.021
Peripheral venous access	36	50	41	79	77	62	0.56 [0.35-0.90]	0.017
6^th cycle of chemotherapy	14	19	24	44	38	30	0.23 [0.07-0.70]	0.01
Oxaliplatin	26	36	7	13	33	26	1.63 [1.00-2.65]	0.049
Carboplatin	8	11	14	26	22	17	0.40 [0.18-0.89]	0.025
Saline solution to prepare chemotherapy	18	25	2	4	20	16	1.85 [1.08-3.17]	0.026
Peripheral sensory neuropathy degree 1	27	37	1	2	28	22	6.45 [3.40-12.24]	<0.001
Peripheral sensory neuropathy degree 2	21	29	0	0	21	17	4.13 [2.12-8.03]	<0.001
Peripheral sensory neuropathy degree 3	8	11	0	0	8	0.6	3.38 [1.43-8.02]	0.006
Clinical manifestation in lower limbs (AINQ^\|\|)
Discomfort without contact with ice	51	70	6	11	57	45	3.18 [1.83-5.51]	<0.001
Tingling (paresthesia) degree 1	26	36	0	0	26	20	3.79 [2.07-6.97]	<0.001
Tingling (paresthesia) degree 2	14	19	0	0	14	11	3.06 [1.52-6.19]	0.002
Tingling (paresthesia) degree 3	6	8	0	0	6	5	3.26 [1.28-8.29]	0.013
Tingling after contact with ice	8	11	0	0	8	6	7.80 [3.35-18.14]	<0.001
Clinical manifestation in upper limbs (AINQ^\|\|)
Tingling (paresthesia) degree 1	22	30	1	2	23	18	2.75 [1.48-5.11]	0.001
Tingling (paresthesia) degree 2	24	33	0	0	24	19	3.67 [2.04-6.61]	<0.001
Tingling (paresthesia) degree 3	5	7	0	0	5	4	3.02 [1.12-8.16]	0.029
Numbness (dysesthesia) degree 1	24	33	0	0	24	19	2.76 [1.57-5.01]	0.001
Numbness (dysesthesia) degree 2	22	30	0	0	22	17	3.46 [1.91-6.26]	<0.001
Difficulties feeling cold	10	14	0	0	10	8	2.18 [1.11 -4.31]	0.024
Heightened sensitivity to touch	6	8	0	0	6	5	2.61 [1.12-6.06]	0.026
Discomfort after contact with ice	5	7	0	0	5	4	3.24 [1.16-9.05]	0.025
Other clinical manifestations
Difficulties when touching cold things	16	22	1	2	17	13	1.79 [1.02-3.12]	0.041
Heightened sensitivity to touch	18	25	0	0	18	14	2.65 [1.54-4.57]	<0.001
Peripheral discomfort after contact with ice	13	18	1	2	14	11	5.06 [2.39-10.71]	<0.001
Peripheral discomfort without contact with ice	45	62	2	4	47	37	4.15 [2.31-7.47]	<0.001
Lack of/decreased touch sensitivity	56	77	0	0	56	44	3.64 [2.11-6.30]	<0.001
Decreased sensitivity	68	93	0	0	68	54	13.27 [5.35-32.96]	<0.001
Difficulties performing manual tasks	14	19	1	2	15	12	2.08 [1.16-3.75]	0.015
Feeling as if stepping on sand	27	37	0	0	27	21	1.96 [1.21-3.16]	0.006
Stinging/stabbing pain in upper limbs	23	32	1	2	24	19	3.16 [1.91-5.23]	<0.001

Variables	HR*	CI 95%^†	p^‡
Metastases
Bone	0.04	0.01-0.39	0.004
Hepatic	10.4	3.75-28.7	<0.001
Regional lymph node	0.26	0.07-0.95	0.041
Alcoholism	10.9	2.66-44.5	0.001
Palliative chemotherapy	0.52	0.27-0.93	0.029
Discomfort in lower limbs	3.56	1.69-7.47	0.001