Survival Prediction in Terminally Ill Cancer Patients: Laboratory Variables and Prospective Validation of The Palliative Prognostic Index.
- Author:
Hyo Rim SON
1
;
Dae Eun KIM
;
Hyun Wook KANG
;
Ha Na KIM
;
Il Kook SEO
;
Ju Young YOON
;
Jun Eul HWANG
;
Hyun Jeong SHIM
;
Sang Hee CHO
;
Ik Joo CHUNG
;
Woo Kyun BAE
Author Information
1. Department of Family Medicine, Gwangju Veterans Hospital, Gwangju, Korea.
- Publication Type:Original Article
- Keywords:
Hospice Care;
Survival Analysis;
Bilirubin
- MeSH:
Bilirubin;
Blood Cell Count;
C-Reactive Protein;
Creatinine;
Dyspnea;
Edema;
Gastrointestinal Neoplasms;
Hospice Care;
Hospices;
Humans;
Lactic Acid;
Life Expectancy;
Lymphocytes;
Prospective Studies;
Sensitivity and Specificity;
Survival Analysis;
Survival Rate;
Terminally Ill
- From:Korean Journal of Medicine
2011;81(3):359-365
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The palliative prognostic index (PPI) was designed to predict life expectancy based on clinical symptoms. In this study, a PPI was constructed and used with other biological parameters to predict 3-week survival in patients with advanced cancer. METHODS: The study included 222 patients. The PPI was constructed with five variables (performance status, oral intake, edema, dyspnea at rest, and delirium). PPI scores were grouped as follows: 4 (group 1); > 4 and < or = 6 (group 2); and > 6 (group 3). At admission, seven biological variables (white blood cell count, lymphocyte, C-reactive protein [CRP], bilirubin, albumin, creatinine, and lactate dehydrogenase) were measured. RESULTS: The overall survival duration was 50 days in group 1, 22 days in group 2, and 14 days in groups 3. Using the PPI, a survival of < 3 weeks in group 3 was predicted with a sensitivity of 76.5% and a specificity of 65.4%. The important factors significantly affecting the 3-week survival rate were a PPI score > 6 and increases in serum bilirubin and CRP levels. Furthermore, the 3-week survival rate in patients with hepatopancreatobiliary cancer was more accurately predicted using a combination of the PPI, CRP, and serum bilirubin levels. CONCLUSIONS: Although a PPI has limitations, it can be quickly applied to determine survival duration in patients admitted to hospice and accurately predicts 3-week survival. Furthermore, bilirubin and CRP are useful factors for predicting 3-week survival in patients with gastrointestinal cancer, including hepatopancreatobiliary cancer.
