Johannes Just1, Marie-Therese Schmitz2, Ulrich Grabenhorst3, Thomas Joist3, Kirsten Horn3, Bettina Engel4, Klaus Weckbecker5. 1. Institute of General Practice and Interprofessional Care Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58453, Witten, Germany. johannes.just@uni-wh.de. 2. Department of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. 3. VSTN e.V. (Association of SAPV Teams in North Rhine), Venloer Straße 40, 41751, Viersen, Germany. 4. Division of General Practice, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26129, Oldenburg, Germany. 5. Institute of General Practice and Interprofessional Care Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58453, Witten, Germany.
Abstract
BACKGROUND: Quality of life and patient self-determination are key elements in successful palliative care. To achieve these goals, a robust prediction of the remaining survival time is useful as it can provide patients and their relatives with information for individual goal setting including appropriate priorities. The Aim of our study was to assess factors that influence survival after enrollment into ambulatory palliative care. METHODS: In this cross-sectional, multicenter study (n = 14 study centers) clinical records of all palliative care patients who were treated in 2017 were extracted and underwent statistical analysis. The main outcome criterion was the association of survival time with clinical characteristics such as age, type of disease, symptoms and performance status. RESULTS: A total of 6282 cases were evaluated. Median time of survival was 26 days (95 % CI: 25-27 days). The strongest association for an increased hazard ratio was found for the following characteristics: moderate/severe weakness (aHR: 1.91; 95 % CI: 1.27-2.86) Karnofsky score 10-30 (aHR: 1.80; 95 % CI: 1.67-1.95), and age > 85 (aHR: 1.50; 95 % CI: 1.37-1.64). Surprisingly, type of disease (cancer vs. non-cancer) was not associated with a change in survival time (aHR: 1.03; 95 % CI: 0.96-1.10). CONCLUSIONS: In this cross-sectional study, the most relevant predictor for a short survival time in specialized ambulatory palliative care was the performance status while type of disease was irrelevant to survival.
BACKGROUND: Quality of life and patient self-determination are key elements in successful palliative care. To achieve these goals, a robust prediction of the remaining survival time is useful as it can provide patients and their relatives with information for individual goal setting including appropriate priorities. The Aim of our study was to assess factors that influence survival after enrollment into ambulatory palliative care. METHODS: In this cross-sectional, multicenter study (n = 14 study centers) clinical records of all palliative care patients who were treated in 2017 were extracted and underwent statistical analysis. The main outcome criterion was the association of survival time with clinical characteristics such as age, type of disease, symptoms and performance status. RESULTS: A total of 6282 cases were evaluated. Median time of survival was 26 days (95 % CI: 25-27 days). The strongest association for an increased hazard ratio was found for the following characteristics: moderate/severe weakness (aHR: 1.91; 95 % CI: 1.27-2.86) Karnofsky score 10-30 (aHR: 1.80; 95 % CI: 1.67-1.95), and age > 85 (aHR: 1.50; 95 % CI: 1.37-1.64). Surprisingly, type of disease (cancer vs. non-cancer) was not associated with a change in survival time (aHR: 1.03; 95 % CI: 0.96-1.10). CONCLUSIONS: In this cross-sectional study, the most relevant predictor for a short survival time in specialized ambulatory palliative care was the performance status while type of disease was irrelevant to survival.
Authors: Marco Maltoni; Augusto Caraceni; Cinzia Brunelli; Bert Broeckaert; Nicholas Christakis; Steffen Eychmueller; Paul Glare; Maria Nabal; Antonio Viganò; Philip Larkin; Franco De Conno; Geoffrey Hanks; Stein Kaasa Journal: J Clin Oncol Date: 2005-09-01 Impact factor: 44.544