Mari Tanaka1, Natsuko Kawai2, Norihiro Yuasa3. 1. Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. 2. Department of Palliative Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. 3. Department of Palliative Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. nyuasa0257@gmail.com.
Abstract
BACKGROUND: Some studies have developed a scoring system to determine the short-term survival of patients with respiratory malignancy. METHODS: A total of 649 terminally ill patients with respiratory malignancy admitted to our palliative care unit were included in this study. They were randomly divided into the investigation (n = 390) and validation (n = 259) groups. Nineteen blood parameters were analyzed in the laboratory. Receiver-operating characteristic analysis was performed for each blood factor and the area under the curve was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify the significant independent prognostic factors for 14-day mortality. To develop a scoring system, the laboratory prognostic score for respiratory malignancy (R-LPS) was calculated using the sum of the indices of the independent prognostic factors. RESULTS: Multivariable analysis showed that 8 out of 19 indices, namely, C-reactive protein ≥ 6.8 mg/dL, aspartate aminotransferase ≥ 43 U/L, blood urea nitrogen ≥ 22 mg/dL, white blood cell count ≥ 10.9 × 103/μL, eosinophil percentage ≤ 0.4%, neutrophil-to-lymphocyte ratio ≥ 12.0, red cell distribution width ≥ 16.8, and platelet count ≤ 168 × 103/μL were significant independent factors for 14-day survival in patients with respiratory malignancy. The R-LPS 3 showed acceptable accuracy for 14-day mortality in both the investigation and validation groups and predicted death within 14 days with 75-82% sensitivity and 59-62% specificity. CONCLUSIONS: The R-LPS developed from eight laboratory indices showed acceptable prognostic ability for terminally ill patients with respiratory malignancy.
BACKGROUND: Some studies have developed a scoring system to determine the short-term survival of patients with respiratory malignancy. METHODS: A total of 649 terminally ill patients with respiratory malignancy admitted to our palliative care unit were included in this study. They were randomly divided into the investigation (n = 390) and validation (n = 259) groups. Nineteen blood parameters were analyzed in the laboratory. Receiver-operating characteristic analysis was performed for each blood factor and the area under the curve was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify the significant independent prognostic factors for 14-day mortality. To develop a scoring system, the laboratory prognostic score for respiratory malignancy (R-LPS) was calculated using the sum of the indices of the independent prognostic factors. RESULTS: Multivariable analysis showed that 8 out of 19 indices, namely, C-reactive protein ≥ 6.8 mg/dL, aspartate aminotransferase ≥ 43 U/L, blood urea nitrogen ≥ 22 mg/dL, white blood cell count ≥ 10.9 × 103/μL, eosinophil percentage ≤ 0.4%, neutrophil-to-lymphocyte ratio ≥ 12.0, red cell distribution width ≥ 16.8, and platelet count ≤ 168 × 103/μL were significant independent factors for 14-day survival in patients with respiratory malignancy. The R-LPS 3 showed acceptable accuracy for 14-day mortality in both the investigation and validation groups and predicted death within 14 days with 75-82% sensitivity and 59-62% specificity. CONCLUSIONS: The R-LPS developed from eight laboratory indices showed acceptable prognostic ability for terminally ill patients with respiratory malignancy.
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