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Published in: Supportive Care in Cancer 1/2014

01-01-2014 | Original Article

Development and validation of a prognostic scale for hospitalized patients with terminally ill cancer in China

Authors: Yu Huang, Qingsong Xi, Shu Xia, Xushi Wang, Yong Liu, Chao Huang, Wei Zheng, Shiying Yu

Published in: Supportive Care in Cancer | Issue 1/2014

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Abstract

Purpose

The purpose of this study is to develop and validate a scale prognostic of survival in hospitalized, terminally ill cancer patients in China.

Methods

Terminally ill cancer patients hospitalized at two general hospitals in China were prospectively analyzed. Patients were divided into a training cohort (n = 181) and a testing cohort (n = 128). Factors prognostic of survival were identified in the training cohort and combined into a scale, which was validated in the testing cohort.

Results

In the training cohort, eight factors associated with reduced survival were identified: low performance status, dyspnea at rest, reduced oral intake, cognitive impairment, edema, leukocytosis, and elevated urea and alanine transaminase concentrations. A prognostic prediction score was calculated for each patient, based on the weight of these eight predictors in the regression model, with scores ranging from 0 (no altered variables) to 12 (maximal altered variables). Patients with different prognostic scores had significantly different prognoses (p < 0.001). A cutoff point of ≥4 was optimal in categorizing patients with “low” (score <4) and “high” (score ≥4) risk of survival for less than 30 days, with median survival time in these groups of 47 and 9 days, respectively. Using this cutoff point on the testing cohort, median survival time for the low and high risk groups were 66 and 11 days, respectively.

Conclusion

We identified eight indicators predictive of poor survival in Chinese patients hospitalized with terminal cancer. A prognostic scale that includes these indicators may help in making decisions about end-of-life care.
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Metadata
Title
Development and validation of a prognostic scale for hospitalized patients with terminally ill cancer in China
Authors
Yu Huang
Qingsong Xi
Shu Xia
Xushi Wang
Yong Liu
Chao Huang
Wei Zheng
Shiying Yu
Publication date
01-01-2014
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 1/2014
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-013-1970-9

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