Correlation of Palliative Performance Scale and Survival in Patients With Cancer Receiving Home-Based Palliative Care

2018 ◽  
Vol 33 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Jiaoli Cai ◽  
Denise N. Guerriere ◽  
Hongzhong Zhao ◽  
Peter C. Coyte
Keyword(s):  
Palliative Care ◽  
Survival Time ◽  
Cox Regression ◽  
Care Program ◽  
Survival Times ◽  
Telephone Interviews ◽  
Kaplan Meier ◽  
Home Based ◽  
A Prospective Study ◽  
Performance Scale

The main objective of this study was to examine whether and how the Palliative Performance Scale (PPS), a measure of a patient’s function, was predictive of survival time for those in receipt of home-based palliative care. This was a prospective study, which included 194 cancer patients from November 17, 2013, to August 18, 2015. Data were collected from biweekly telephone interviews with caregivers. Kaplan-Meier survival curves were estimated to assess how survival time was correlated with initial PPS scores after admission to the home-based palliative care program. A multivariate extended Cox regression model was used to examine the association between PPS and survival. The results showed that patients with higher PPS scores, that is, better function, had a lower hazard ratio (0.977; 95% confidence interval: 0.965-0.989) and hence longer survival times. The PPS can be used in predicting survival time for home-based palliative care patients.

Palliative Performance Scale Score at 1 Week After Palliative Care Unit Admission is More Useful for Survival Prediction in Patients With Advanced Cancer in South Korea

2018 ◽  
Vol 35 (9) ◽  
pp. 1168-1173 ◽  
Author(s):  
Seok-Joon Yoon ◽  
Sung-Eun Choi ◽  
Thomas W. LeBlanc ◽  
Sang-Yeon Suh
Keyword(s):  
Palliative Care ◽  
South Korea ◽  
Survival Time ◽  
Advanced Cancer ◽  
Cox Regression ◽  
Prognostic Index ◽  
Palliative Care Unit ◽  
Survival Prediction ◽  
Performance Scale ◽  
Over Time

Background: The Palliative Performance Scale (PPS) is a useful prognostic index in palliative care. Changes in PPS score over time may add useful prognostic information beyond a single measurement. Objective: To investigate the usefulness of repeated PPS measurement to predict survival time of inpatients with advanced cancer admitted to a palliative care unit (PCU) in South Korea. Design: Prospective observational cohort study. Setting/Patients: 138 patients with advanced cancer admitted to a PCU in a university hospital in South Korea from June 2015 to May 2016. Measurements: The PPS score was measured on enrollment and after 1 week. We used Cox regression analyses to calculate hazard ratios (HRs) to demonstrate the relationship between survival time and the groups categorized by PPS and changes in PPS score, after adjusting for clinical variables. Results: There were significant differences in survival time among 3 groups stratified by PPS (10-20, 30-50, and ≥60) after 1 week. A group with a PPS of 10 to 20 at 1 week had the highest risk (HR: 5.18 [95% confidence interval, 1.57-17.04]) for shortened survival. On the contrary, there were no significant differences among these groups by initial PPS alone. Similarly, change in PPS was prognostic; median survival was 13 (10.96-15.04) days for those whose PPS decreased after 1 week and 27 (10.18-43.82) days for those with stable or increased PPS ( P < .001). Conclusions: Measuring PPS over time can be very helpful for predicting survival in terminally ill patients with cancer, beyond a single PPS measure at PCU admission.

scholarly journals Survival after surgery among patients with cholangiocarcinoma in Northeast Thailand according to anatomical and morphological classification

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chaiwat Tawarungruang ◽  
Narong Khuntikeo ◽  
Nittaya Chamadol ◽  
Vallop Laopaiboon ◽  
Jaruwan Thuanman ◽  
...  
Keyword(s):  
Survival Rate ◽  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Cox Regression ◽  
Survival Rates ◽  
Care Program ◽  
Tumor Location ◽  
Northeast Thailand ◽  
Curative Surgery

Abstract Background Cholangiocarcinoma (CCA) has been categorized based on tumor location as intrahepatic (ICCA), perihilar (PCCA) or distal (DCCA), and based on the morphology of the tumor of the bile duct as mass forming (MF), periductal infiltrating (PI) or intraductal (ID). To date, there is limited evidence available regarding the survival of CCA among these different anatomical and morphological classifications. This study aimed to evaluate the survival rate and median survival time after curative surgery among CCA patients according to their anatomical and morphological classifications, and to determine the association between these classifications and survival. Methods This study included CCA patients who underwent curative surgery from the Cholangiocarcinoma Screening and Care Program (CASCAP), Northeast Thailand. The anatomical and morphological classifications were based on pathological findings after surgery. Survival rates of CCA and median survival time since the date of CCA surgery and 95% confidence intervals (CI) were calculated. Multiple cox regression was performed to evaluate factors associated with survival which were quantified by hazard ratios (HR) and their 95% CIs. Results Of the 746 CCA patients, 514 had died at the completion of the study which constituted 15,643.6 person-months of data recordings. The incidence rate was 3.3 per 100 patients per month (95% CI: 3.0–3.6), with median survival time of 17.8 months (95% CI: 15.4–20.2), and 5-year survival rate of 24.6% (95% CI: 20.7–28.6). The longest median survival time was 21.8 months (95% CI: 16.3–27.3) while the highest 5-year survival rate of 34.8% (95% CI: 23.8–46.0) occurred in the DCCA group. A combination of anatomical and morphological classifications, PCCA+ID, was associated with the longest median survival time of 40.5 months (95% CI: 17.9–63.0) and the highest 5-year survival rate of 42.6% (95% CI: 25.4–58.9). The ICCA+MF combination was associated with survival (adjusted HR: 1.45; 95% CI: 1.01–2.09; P = 0.013) compared to ICCA+ID patients. Conclusions Among patients receiving surgical treatment, those with PCCA+ID had the highest 5-year survival rate, which was higher than in groups classified by only anatomical characteristics. Additionally, the patients with ICCA+MF tended to have unfavorable surgical outcomes. Showed the highest survival association. Therefore, further investigations into CCA imaging should focus on patients with a combination of anatomical and morphological classifications.

scholarly journals Cox proportion hazard model for patients with hepatitis disease in Iraq

2009 ◽  
Vol 6 (3) ◽  
pp. 612-617
Author(s):  
Baghdad Science Journal
Keyword(s):  
Regression Model ◽  
Survival Time ◽  
Cox Regression ◽  
Survival Function ◽  
Hazard Model ◽  
Cox Regression Model ◽  
Hepatic Diseases ◽  
Kaplan Meier

Cox regression model have been used to estimate proportion hazard model for patients with hepatitis disease recorded in Gastrointestinal and Hepatic diseases Hospital in Iraq for (2002 -2005). Data consists of (age, gender, survival time terminal stat). A Kaplan-Meier method has been applied to estimate survival function and hazerd function.

Cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure

2017 ◽  
Vol 32 (2) ◽  
pp. 476-484 ◽  
Author(s):  
Frances Kam Yuet Wong ◽  
Ching So ◽  
Alina Yee Man Ng ◽  
Po-Tin Lam ◽  
Jeffrey Sheung Ching Ng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Cost Effectiveness ◽  
Care Program ◽  
Palliative Care Program ◽  
Home Based ◽  
End Stage Heart Failure ◽  
End Stage ◽  
Transitional Home

scholarly journals Occurrence of preterm calving in Great Britain and associations with milk production and reproductive performance in dairy cattle

2018 ◽  
Vol 5 (1) ◽  
pp. e000221 ◽  
Author(s):  
Angela Filipa Damaso ◽  
Martina Velasova ◽  
Steven Van Winden ◽  
Yu-mei Chang ◽  
Javier Guitian
Keyword(s):  
Great Britain ◽  
Milk Production ◽  
Milk Protein ◽  
Cox Regression ◽  
Study Groups ◽  
Survival Times ◽  
Kaplan Meier ◽  
Butter Fat ◽  
Potential Risk Factors ◽  
On Farm

This study describes the occurrence of preterm calving in Great Britain and evaluates its associations with subsequent milk production and reproductive performances and survival on farm of dairy cows. A total of 53 British dairy farms and 5759 animals with detailed breeding and milk recording data available were used to form two study groups: preterm calving (calving occurring between days 266 and 277 of gestation) and full-term calving (calving occurring at 278 days of gestation and over). Mixed effects models were implemented to compare milk production, clinical cases of mastitis and number of services per conception between groups. Kaplan-Meier curves and Cox regression analyses compared time from calving to conception, calving interval and survival on farm between groups. Preterm calving cows showed significantly lower milk yield (P<0.01) and butter fat per cent (P=0.02), increased milk protein per cent (P=0.01), longer survival on farm (P<0.01), and a tendency for shorter calving to conception intervals and fewer services per conception, although other factors were involved in the reproduction outcomes. Experiencing a preterm calving is associated with lower milk production and longer survival times on farm. Potential risk factors for preterm calving, such as infectious diseases, diet and husbandry practices, should be further investigated.

Activities of daily living at hospital admission and estimated survival time of older patients

2020 ◽  
Author(s):  
Jesper Ryg ◽  
Henriette Engberg ◽  
Pavithra Laxsen Anru ◽  
Solvejg Gram Henneberg Pedersen ◽  
Martin Gronbech Jorgensen ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Activities Of Daily Living ◽  
Survival Time ◽  
Barthel Index ◽  
Daily Living ◽  
Older Patients ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Population Based ◽  
Kaplan Meier

Abstract Background Predicting expected survival time in acutely hospitalised older patients is a clinical challenge. Objective To examine if activities of daily living (ADL) assessed by Barthel-Index-100 (Barthel-Index) at hospital admission adds useful information to clinicians on expected survival time in older patients. Methods A nationwide population-based cohort study was used. All patients aged ≥65 years in the National Danish Geriatric Database from 2005 to 2014 were followed up until death, emigration or study termination (31 December 2015). Individual data were linked to national health registers. Barthel-Index was categorised into five-point subcategories with a separate category of Barthel-Index = 0. Kaplan–Meier analysis was used to assess crude survival proportions (95% CI) and Cox regression to examine association of Barthel-Index and mortality adjusting for age, Charlson comorbidity index, medication use, BMI, marital status, prior hospitalisations and admission year. Results In total, 74,589 patients (63% women) aged (mean (SD)) 82.5(7.5) years with Barthel-Index (median (IQR)) 54(29-77) were included. In patients with Barthel-Index = 100-96 crude survival was 0.96(0.95-0.97) after 90-days, 0.88(0.87-0.89) after 1-year, and 0.79(0.78-0.80) after 2-years. Corresponding survival in patients with Barthel-Index = 0 was 0.49(0.47-0.51), 0.35(0.34-0.37) and 0.26(0.24-0.27). Decreasing Barthel-Index was associated with increasing mortality in the multivariable analysis. In women with Barthel-Index = 0, the mortality risk (HR (95% CI)) was 14.74(11.33-19.18) after 90-days, 8.40(7.13-9.90) after 1-year and 6.22(5.47-7.07) after 2-years using Barthel-Index = 100-96 as reference. In men, the corresponding risks were 11.36(8.81-14.66), 6.22(5.29-7.31) and 5.22(4.56-5.98). Conclusions ADL measured by Barthel-Index provides useful, easily accessible and independent information to clinicians on expected survival time in patients admitted to a geriatric department.

Incidence of secondary malignancies (SM) in patients (pts) with germ cell tumors (GCT) who received high-dose chemotherapy (HDCT): A retrospective study from the European Society for Blood and Marrow Transplantation (EBMT) database.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4549-4549
Author(s):  
Simona Secondino ◽  
Andrea Necchi ◽  
Giovanni Rosti ◽  
Manuela Badoglio ◽  
Daniele Raggi ◽  
...  
Keyword(s):  
Cox Regression ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Survival Times ◽  
Blood And Marrow Transplantation ◽  
Kaplan Meier ◽  
European Database ◽  
Long Term Follow Up ◽  
Retrospective Nature

4549 Background: Little is still known about the incidence of SM in young adult pts with GCT after HDCT, owing to the rarity of the disease, and the need for registries with long term follow-up (FUP) data. In Europe, the EBMT may provide a suitable platform for such retrospective analyses. Methods: Criteria for patient selection included diagnosis of GCT, adult male gender, ≥2yr of FUP after the administration of HDCT. Summary statistics were used to describe pt characteristics and outcomes. χ2 tests were used to compare groups according to the length of FUP. Kaplan-Meier estimates were used to estimate overall survival (OS). Univariable Cox regression analyses examined clinical factors potentially associated with OS. Survival times were calculated from the HDCT administration date. To estimate the probability of developing SM, the cumulative incidence of SM was calculated for all pts. Results: From 1981 to 2014, 9,153 autografts, accounting for 5,100 pts, have been registered. Of them, 1,855 had ≥2yr of FUP. Among the latter, a total of 56 cases of SM were identified (3.0%). 28 (50%) had solid SM, 22 (39.3%) hematologic (hem) SM (5 had uncoded SM). Median age at first HDCT was 34 years (IQR: 30-42), median age at development of SM was 42 (37-51). 26 pts (46.4%) received single HDCT cycle, 22 (39.3%) multiple HDCT cycles (8 unknown). 31 pts had ≥5 yr FUP, 25 pts 2-5 yr FUP. The median latency of SM was 3.3yrs (IQR: 1.8-6.1) for hem SM and 5.6yrs (IQR: 1.2-10.8) for solid SM. Median FUP was 6.4yrs. Univariably, the type of SM (solid vs. hem) was significantly associated with OS. Hem vs solid SM: HR: 2.17 (95%CI: 1.19-4.97, p = 0.020). Median OS of pts who developed solid SM was 13.3yrs compared to 4.1yrs of those with hem SM. The retrospective nature of the data is the major limitation. Conclusions: In the largest European database of SM in GCT pts, we observed different trends for SM development according to the SM type. This information may be important for FUP guidelines of these pts. Dataset implementation is ongoing and we will compare the SM incidence from EBMT database with SM rates in the general EU population.

Effectiveness of a Home-Based Palliative Care Program for End-of-Life

2003 ◽  
Vol 6 (5) ◽  
pp. 715-724 ◽  
Author(s):  
Richard D. Brumley ◽  
Susan Enguidanos ◽  
David A. Cherin
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Program ◽  
Palliative Care Program ◽  
Home Based

scholarly journals Effect of a Home‐Based Palliative Care Program on Healthcare Use and Costs

2016 ◽  
Vol 64 (11) ◽  
pp. 2288-2295 ◽  
Author(s):  
J. Brian Cassel ◽  
Kathleen M. Kerr ◽  
Donna K. McClish ◽  
Nevena Skoro ◽  
Suzanne Johnson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Program ◽  
Palliative Care Program ◽  
Healthcare Use ◽  
Home Based

scholarly journals Waist-to-Hip Ratio, Cardiovascular Outcomes, and Death in Peritoneal Dialysis Patients

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Winnie S. Su ◽  
Catherine M. Clase ◽  
K. Scott Brimble ◽  
Peter J. Margetts ◽  
Trevor J. Wilkieson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Obesity ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Primary Objective ◽  
Waist To Hip Ratio ◽  
Kaplan Meier ◽  
Analysis Survival ◽  
A Prospective Study ◽  
The Relationship

Objectives. The primary objective of this study was to determine the relationship between waist-to-hip ratio (WHR), cardiovascular (CV) events, and mortality in peritoneal dialysis (PD) patients. A secondary objective was to investigate the association between abdominal obesity and systemic inflammatory markers.Methods. This is a prospective study of 22 prevalent PD patients. WHR was measured at baseline. C-reactive protein (CRP), tumour necrosis factor-α(TNF-α), and interleukin-6 (IL-6) were measured. Main outcomes were first CV event and death from all causes. Survival analysis was used to examine the relationship between anthropomorphic measures and clinical outcomes.Results. Mean follow-up period was 3.1 years. In Kaplan-Meier analysis, survival was lower in those with higher WHR (P=.002). In Cox regression, WHR independently predicted mortality and first CV event after adjustment for known ischemic heart disease (hazard ratio [HR] 1.17, confidence interval [CI] 1.05–1.30 for death; HR 1.13, CI 1.01–1.26 for CV event). WHR correlated with serum TNF-α(r=0.45;P=.05).Conclusion. The results of this study suggest WHR may be a risk factor for increased CV events and mortality in PD patients. Abdominal obesity is also associated with inflammatory markers. Larger studies are warranted to confirm these findings.

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