Yen-Ting Chen1, Chih-Te Ho2, Hua-Shai Hsu2, Po-Tsung Huang1, Chin-Yu Lin3, Chiu-Shong Liu4, Tsai-Chung Li5, Cheng-Chieh Lin6, Wen-Yuan Lin7. 1. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan. 2. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan. 3. Department of Nursing, China Medical University Hospital, Taichung, Taiwan. 4. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan. 5. Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan; Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan. 6. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan. 7. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: wylin@mail.cmu.edu.tw.
Abstract
CONTEXT: The accurate prediction of survival is one of the key factors in the decision-making process for patients with advanced illnesses. OBJECTIVES: This study aimed to develop a short-term prognostic prediction method that included such objective factors as medical history, vital signs, and blood tests for use with patients with advanced cancer. METHODS: Medical records gathered at the admission of patients with advanced cancer to the hospice palliative care unit at a tertiary hospital in Taiwan were reviewed retrospectively. The records included demographics, history of cancer treatments, performance status, vital signs, and biological parameters, Multivariate logistic regression analyses and receiver operating characteristic curves were used for model development. RESULTS: The Objective Palliative Prognostic Score was determined by using six objective predictors identified by multivariate logistic regression analysis. The predictors include heart rate >120/min, white blood cells >11,000/mm(3), platelets <130,000/mm(3), serum creatinine level >1.3 mg/dL, serum potassium level >5 mg/dL, and no history of chemotherapy. The area under the receiver operating characteristic curve used to predict seven-day survival was 82.0% (95% confidence interval 75.2%-88.8%). If any three predictors of the six were reached, death within seven days was predicted with 68.8% sensitivity, 86.0% specificity, 55.9% positive predictive value, and 91.4% negative predictive value. CONCLUSION: The Objective Palliative Prognostic Score consists of six objective predictors for the estimation of seven-day survival among patients with advanced cancer and showed a relatively high accuracy, specificity, and negative predictive value. Objective signs, such as vital signs and blood test results, may help clinicians make decisions at the end of life.
CONTEXT: The accurate prediction of survival is one of the key factors in the decision-making process for patients with advanced illnesses. OBJECTIVES: This study aimed to develop a short-term prognostic prediction method that included such objective factors as medical history, vital signs, and blood tests for use with patients with advanced cancer. METHODS: Medical records gathered at the admission of patients with advanced cancer to the hospice palliative care unit at a tertiary hospital in Taiwan were reviewed retrospectively. The records included demographics, history of cancer treatments, performance status, vital signs, and biological parameters, Multivariate logistic regression analyses and receiver operating characteristic curves were used for model development. RESULTS: The Objective Palliative Prognostic Score was determined by using six objective predictors identified by multivariate logistic regression analysis. The predictors include heart rate >120/min, white blood cells >11,000/mm(3), platelets <130,000/mm(3), serum creatinine level >1.3 mg/dL, serum potassium level >5 mg/dL, and no history of chemotherapy. The area under the receiver operating characteristic curve used to predict seven-day survival was 82.0% (95% confidence interval 75.2%-88.8%). If any three predictors of the six were reached, death within seven days was predicted with 68.8% sensitivity, 86.0% specificity, 55.9% positive predictive value, and 91.4% negative predictive value. CONCLUSION: The Objective Palliative Prognostic Score consists of six objective predictors for the estimation of seven-day survival among patients with advanced cancer and showed a relatively high accuracy, specificity, and negative predictive value. Objective signs, such as vital signs and blood test results, may help clinicians make decisions at the end of life.
Authors: David Hui; Carlos Eduardo Paiva; Egidio G Del Fabbro; Christopher Steer; Jane Naberhuis; Marianne van de Wetering; Paz Fernández-Ortega; Tatsuya Morita; Sang-Yeon Suh; Eduardo Bruera; Masanori Mori Journal: Support Care Cancer Date: 2019-03-13 Impact factor: 3.603
Authors: Lea Kum; Alexander Friedrich; Markus Kieler; Elias Meyer; Petar Popov; Paul Kössler; Anna Kitta; Feroniki Adamidis; Raimund Oberle; Eva Katharina Masel; Matthias Unseld Journal: Nutrients Date: 2022-02-11 Impact factor: 5.717