Longitudinal symptom dynamics in postoperative patients with liver cancer: A cross-lagged panel network analysis.
Postoperative symptom dynamics in liver cancer patients show that jaundice and vomiting are key early symptoms, while sadness becomes more central later on.
Where it sits
this study against the rest of the evuzamitide corpusSummary and findings
This study investigated postoperative symptom dynamics in 230 patients with liver cancer using a cross-lagged panel network model. Symptoms were assessed at five time points post-surgery. Key findings include significant predictive relationships among symptoms such as jaundice predicting vomiting and sadness predicting disturbed sleep.
Abstract
<h4>Objective</h4>This study aimed to investigate the dynamic temporal associations among postoperative symptoms in patients with liver cancer using a cross-lagged panel network (CLPN) model, and to identify stage-specific core symptoms to inform targeted clinical interventions.<h4>Methods</h4>A longitudinal study was conducted involving 230 patients with liver cancer. Symptoms were assessed using the MD Anderson Symptom Inventory (MDASI) and the Symptom Module Specific to Primary Liver Cancer (SM-PLC) at five time points: 2 days (T1), 1 week (T2), 3 weeks (T3), 1 month (T4), and 3 months (T5) postoperatively. A CLPN model was applied to estimate cross-lagged associations among symptoms. Out-expected influence (out-EI) and in-expected influence (in-EI) were calculated to identify central symptoms within the dynamic network.<h4>Results</h4>From T1 to T2, jaundice exhibited the highest out-EI and significantly predicted vomiting (OR = 1.94, 95% CI [1.70, 2.14]). Pruritus predicted numbness (OR = 1.41, 95% CI [1.31, 1.52]), and pain predicted sadness (OR = 1.35, 95% CI [1.05, 1.47]). From T2 to T3, vomiting showed the highest out-EI and predicted jaundice (OR = 2.64, 95% CI [2.17, 2.84]), while bidirectional associations were observed between numbness and pruritus (OR = 2.64, 95% CI [2.17, 2.74]; OR = 1.21, 95% CI [1.00, 1.71]). From T3 to T4, vomiting predicted bloating (OR = 1.57, 95% CI [1.00, 1.64]) and loss of appetite (OR = 1.41, 95% CI [1.07, 1.62]), while fever predicted loss of appetite (OR = 1.28, 95% CI [1.14, 1.42]). From T4 to T5, sadness exhibited the highest out-EI and predicted disturbed sleep (OR = 1.35, 95% CI [1.22, 1.47]), loss of appetite (OR = 1.21, 95% CI [1.15, 1.46]), and fatigue (OR = 1.26, 95% CI [1.15, 1.51]).<h4>Conclusions</h4>Postoperative symptom dynamics in patients with liver cancer demonstrate clear stage-specific patterns. Jaundice and vomiting dominate early postoperative phases, whereas sadness becomes the central symptom in later stages. These findings may inform time-sensitive and symptom-targeted nursing interventions to improve postoperative symptom management.