Survival prediction for advanced cancer patients in the real world: A comparison of the Palliative Prognostic Score, Delirium-Palliative Prognostic Score, Palliative Prognostic Index and modified Prognosis in Palliative Care Study predictor model

2015 ◽  
Vol 51 (12) ◽  
pp. 1618-1629 ◽  
Author(s):  
Mika Baba ◽  
Isseki Maeda ◽  
Tatsuya Morita ◽  
Satoshi Inoue ◽  
Masayuki Ikenaga ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Real World ◽  
Prognostic Score ◽  
Prognostic Index ◽  
Survival Prediction ◽  
Advanced Cancer Patients ◽  
Palliative Prognostic Index ◽  
Predictor Model ◽  
Care Study

Palliative Prognostic Index application at an inpatient palliative care service from a Brazilian tertiary Hospital: A prospective observational study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11537-11537
Author(s):  
Tiago Pugliese Branco ◽  
Alze Pereira dos Santos Tavares ◽  
Mariana Sarkis Braz ◽  
Mariana Ribeiro Monteiro ◽  
Ana Beatriz Kinupe Abrahao ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Service ◽  
Prognostic Index ◽  
Palliative Care Service ◽  
Tertiary Hospital ◽  
Care Physician ◽  
Survival Prediction ◽  
Advanced Cancer Patients

11537 Background: Palliative Care Index (PPI) has been proposed to improve the accuracy of survival prediction for advanced cancer patients. The aim of this study is to investigate the feasibility and real-world prognosis survival of oncology inpatients from a Brazilian tertiary hospital using PPI. Methods: Hospitalized advanced cancer patients who have been referred to the Palliative Care Team were enrolled from May 2011 to December 2018. The PPI was collected within 24 hours of the referral by the palliative care physician. Primary endpoint was median overall survival (OS), estimated with the use of the Kaplan–Meier method, in three groups: PPI < 4.0; 4.0 ≤ PPI > 6.0 and PPI ≥ 6.0. Secondary endpoints were OS rate at 3-week for patients with PPI ≥ 6.0, and the most accurate PPI value to predict 6 and 3-week survival, calculated by ROC curve. Results: Total of 1.381 patients were included in this cohort with a median age of 68-year-old, and 51.3% of females. The most frequent primary cancer sites were lung/chest (17,2%), colorectal (14,3%), breast (11,2%), and biliopancreatic (10,9%). Among 454 patients with PPI < 4.0, median OS was 44 days (95% CI: 35,5-52,4); 20 days (95% CI: 15,4-24,5) for 260 patients with 4.0≤ PPI < 6.0 and 8 days (95% CI: 7-8,9) between 655 patients with PPI ≥ 6. Differences in OS among the groups adjusted for primary site, age and gender were significant (p < 0,001). OS rate at 3 weeks for PPI≥ 6.0 was 28.1% (OR 5,39 p < 0.001). PPI value of < 5,5 best predicted 6-week OS (79% sensibility, 55% specificity, AUC 0,714) and the PPI value of ≥ 5,5 predicted 3-week OS (67% sensibility, 73% specificity, AUC 0,753). Conclusions: PPI is feasible and suitable for routine clinical practice to predict survival among Brazilian patients with advanced cancer. In our study, PPI 5.5 seems to be the most accurate value to predict survival within 3 weeks.

scholarly journals Palliative Prognostic Index accuracy of survival prediction in an inpatient palliative care service at a Brazilian tertiary hospital

2021 ◽  
Vol 15 ◽  
Author(s):  
Mauricio Fernandes ◽  
Tago Pugliese Branco ◽  
Maria Clara Navarro Fernandez ◽  
Carolina Paparelli ◽  
Mariana Sarkis Braz ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Prognostic Index ◽  
Palliative Care Service ◽  
Tertiary Hospital ◽  
Survival Prediction ◽  
Palliative Prognostic Index

Unscheduled hospitalization in advanced cancer patients: Time to rethink about the illness.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23007-e23007
Author(s):  
Lorena Ostios-García ◽  
Jesus Miranda Poma ◽  
Darío Sánchez Cabrero ◽  
Laura Gutiérrez Sainz ◽  
Julia Villamayor Sánchez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Median Survival ◽  
Gynecological Cancer ◽  
Prognostic Score ◽  
Prognostic Scores ◽  
Birth Date ◽  
Tumor Type ◽  
Advanced Cancer Patients

e23007 Background: The aim of our study was to determine if an unscheduled hospitalization in advanced cancer patients is a good time for palliative care referrals, and if this indicator could be improved with some other prognostic score. Methods: We conducted a retrospective study, which included all patients with unscheduled hospitalization in the medical oncology service from January 2011 to December 2013. In order to improve the accuracy of the analysis we considered only first admissions of each patient. We excluded patients with scheduled and unindicated hospitalization. The main variable was survival after an unscheduled hospitalization. We collected the following variables: demographic (age, sex, date of birth, date of death and place of death), tumor type, clinical variables (reason for admission, date of hospitalization, assessment by the palliative care unit during hospitalization, date of last chemotherapy and ECOG), analytical variables (albumin, lymphocytes and lactate dehydrogenase) and a prognostic nomogram developed by our team. Results: Inclusion criteria were met by 1,180 patients. Table summarizes the main sociodemographic characteristics, the type of tumor, and the functional status of patients according to the ECOG scale. After two years of follow-up, 816 (69%) patients had died. The median overall survival was 188 days (161-214). Patients with breast and gynecological cancer had the longest survival, while patients with melanoma, gastric cancer, lung cancer, and pancreatic cancer had the poorest survival. 676 patients (58%) were readmitted during the following year. Readmissions meant a significant decrease of survival. The stage of the oncological disease and performance status measured by ECOG had a clear relationship with survival time. Prognostic nomogram showed high accuracy to predict the probability of survival. Median survival for different quartile was respectively: 348, 139, 68 and 31 days (p < 0´000). Conclusions: The median survival of patients after an unscheduled hospitalization was around 6 months. Been admitted seems a good indicator to introduce specific palliative care. The use of other prognostic scores, as a prognostic nomogram, could help to select patient’ groups with poorer survivals. [Table: see text]

Survival prediction of anxious emotion in advanced cancer patients receiving palliative care

2016 ◽  
Vol 26 (10) ◽  
pp. 1463-1469 ◽  
Author(s):  
Weiwei Zhao ◽  
Zhenyu Wu ◽  
Jianhua Chen ◽  
Huixun Jia ◽  
Zhe Huang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Survival Prediction ◽  
Advanced Cancer Patients

scholarly journals Predicting survival in patients with advanced cancer in the last weeks of life: How accurate are prognostic models compared to clinicians’ estimates?

2019 ◽  
Vol 34 (1) ◽  
pp. 126-133 ◽  
Author(s):  
David Hui ◽  
Jeremy Ross ◽  
Minjeong Park ◽  
Rony Dev ◽  
Marieberta Vidal ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Prognostic Score ◽  
Prognostic Index ◽  
Prognostic Scores ◽  
Concordance Index ◽  
Prognostic Accuracy ◽  
Prediction Of Survival ◽  
Palliative Prognostic Index ◽  
Performance Scale

Background: It is unclear if validated prognostic scores such as the Palliative Performance Scale, Palliative Prognostic Index, and Palliative Prognostic Score are more accurate than clinician prediction of survival in patients admitted to an acute palliative care unit with only days of survival. Aim: We compared the prognostic accuracy of Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival in this setting. Design: This is a pre-planned secondary analysis of a prospective study. Setting/participants: We assessed Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival at baseline. We computed their prognostic accuracy using the Concordance index and area under the receiver operating characteristics curve for 7-, 14-, and 30-day survival. Results: A total of 204 patients were included with a median overall survival of 10 days (95% confidence interval: 8–11 days). The Concordance index for Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival were 0.74, 0.71, 0.70, and 0.75, respectively. The areas under the curve for these approaches were 0.82–0.87 for 30-day survival, 0.75–0.80 for 14-day survival, and 0.74–0.81 for 7-day survival. The four prognostic approaches had similar accuracies, with the exception of 7-day survival in which clinician prediction of survival was significantly more accurate than Palliative Prognostic Score (difference: 7%) and Palliative Prognostic Index (difference: 8%). Conclusion: In patients with advanced cancer with days of survival, clinician prediction of survival and Palliative Performance Scale alone were as accurate as Palliative Prognostic Score and Palliative Prognostic Index. These four approaches may be useful for prognostication in acute palliative care units. Our findings highlight how patient population may impact the accuracy of prognostic scores.

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