Factors Associated with Length of Survival among 1081 Terminally Ill Cancer Patients

1995 ◽  
Vol 11 (3) ◽  
pp. 20-24 ◽  
Author(s):  
Pierre Allard ◽  
Albert Dionne ◽  
Diane Potvin
Keyword(s):  
Palliative Care ◽  
Prognostic Factors ◽  
Survival Time ◽  
Cancer Patients ◽  
Performance Status ◽  
Terminally Ill ◽  
Patient Characteristics ◽  
Cancer Site ◽  
Primary Tumor Site ◽  
Terminally Ill Cancer Patients

To improve their ability to estimate the survival of terminally ill cancer patients, palliative care physicians require accurate information on prognostic factors. The objective of this study was to assess the extent to which variables such as patient characteristics and primary tumor site affect the length of survival of terminally ill cancer patients. The study population consisted of 1081 cancer patients admitted for terminal care to a 15-bed palliative care unit from 1985 to 1991. Univariate Kaplan-Meier survival analysis and multivariate Cox regression analyses were used to examine the relationship between patient characteristics at admission and survival time. The factor most strongly associated with shorter survival was poor performance status; this strong relationship was not altered by taking into account sex and primary cancer site in the multivariate analysis. For patients who were bedridden at admission, the death rate was 5.5 times higher (95% confidence interval (CI) 3.4–9.0) than that for ambulatory patients during the first four days of stay and it was 2.8 times higher (95% CI 2.0–3.9) subsequently (up to 19 days). The other prognostic factors significantly but slightly associated with poorer survival in the univariate analysis were primary lung cancer, male sex, and living with a spouse. These findings indicate that performance status is the main prognostic factor for accurately estimating the survival time of terminally ill cancer patients.

scholarly journals Palliative Performance Status, Heart Rate and Respiratory Rate as Predictive Factors of Survival Time in Terminally Ill Cancer Patients

2006 ◽  
Vol 31 (6) ◽  
pp. 485-492 ◽  
Author(s):  
Cristina de Miguel Sánchez ◽  
Sofía Garrido Elustondo ◽  
Alicia Estirado ◽  
Fernando Vicente Sánchez ◽  
Cristina García de la Rasilla Cooper ◽  
...  
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Survival Time ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Performance Status ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients

Effect of interval between diagnosis of advanced cancer and cessation of active anti-cancer treatment on survival in terminally ill cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20630-e20630
Author(s):  
Y. Kim ◽  
J. Lee ◽  
W. Choi ◽  
J. Park ◽  
H. Kim ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Performance Status ◽  
Terminally Ill ◽  
Time Interval ◽  
Terminally Ill Cancer Patients ◽  
Terminal Stage ◽  
Anti Cancer

e20630 Background: Although various prognostic factors have been proposed to predict survival in terminally ill cancer patients, accurate prognostication is still a challenging task for oncologists. The objective of this study was to evaluate whether the time interval between diagnosis of advanced cancer and cessation of active anti-cancer treatment (ATP; active treatment period) can predict survival in terminally ill cancer patients. Methods: We prospectively evaluated 79 patients with advanced (recurrent or metastatic) cancer who were determined as terminal stage, namely cessation of active anti-cancer treatment and transition to palliative care, by attending oncologists. ATP and other known prognostic factors including clinical symptoms and signs, performance status, laboratory tests, and clinical prediction of survival (CPS) were analyzed. Results: Of the 79 patients, 46 were male (58%) and 33 were female (42%) with a median age of 60 years (range, 21–82). Median overall survival after being diagnosed with advanced cancer was 11.6 months (95% confidence interval (CI), 8.02–15.18), and survival after being determined as terminal stage was 1.9 months (95% CI, 1.38–2.42). According to 3 ATP categories (< 3months, 3–12 months, and >12 months), terminal stage survival were 1.0 month, 1.8 months, and 3.6 months, respectively (p=0.002). On multivariate analysis, short ATP, non-colorectal cancer, fatigue, and Karnofsky performance status less than 50 were significantly associated with a poor prognosis. Conclusions: Our study suggests that ATP is an independent prognostic factor for survival in terminally ill cancer patients who cannot receive active anti-cancer treatment anymore. Future prognostic models should include ATP as a prognostic variable. No significant financial relationships to disclose.

Predictive Factors for the Development of Dyspnea Within 7 Days After Admission Among Terminally Ill Cancer Patients

2021 ◽  
pp. 104990912110288
Author(s):  
Ryo Matsunuma ◽  
Takashi Yamaguchi ◽  
Masanori Mori ◽  
Tomoo Ikari ◽  
Kozue Suzuki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Performance Status ◽  
Univariate Analysis ◽  
Terminally Ill ◽  
Primary Lung Cancer ◽  
Poor Performance Status ◽  
Terminally Ill Cancer Patients ◽  
Development Group

Background: Predictive factors for the development of dyspnea have not been reported among terminally ill cancer patients. Objective: This current study aimed to identify the predictive factors attributed to the development of dyspnea within 7 days after admission among patients with cancer. Methods: This was a secondary analysis of a multicenter prospective observational study on the dying process among patients admitted in inpatient hospices/palliative care units. Patients were divided into 2 groups: those who developed dyspnea (development group) and those who did not (non-development group). To determine independent predictive factors, univariate and multivariate analyses using the logistic regression model were performed. Results: From January 2017 to December 2017, 1159 patients were included in this analysis. Univariate analysis showed that male participants, those with primary lung cancer, ascites, and Karnofsky Performance Status score (KPS) of ≤40, smokers, and benzodiazepine users were significantly higher in the development group. Multivariate analysis revealed that primary lung cancer (odds ratio [OR]: 2.80, 95% confidence interval [95% CI]: 1.47-5.31; p = 0.002), KPS score (≤40) (OR: 1.84, 95% CI: 1.02-3.31; p = 0.044), and presence of ascites (OR: 2.34, 95% CI: 1.36-4.02; p = 0.002) were independent predictive factors for the development of dyspnea. Conclusions: Lung cancer, poor performance status, and ascites may be predictive factors for the development of dyspnea among terminally ill cancer patients. However, further studies should be performed to validate these findings.

Verbalized desire for death or euthanasia in advanced cancer patients receiving palliative care

2014 ◽  
Vol 13 (2) ◽  
pp. 295-303 ◽  
Author(s):  
Ernest Güell ◽  
Adelaida Ramos ◽  
Tania Zertuche ◽  
Antonio Pascual
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Well Being ◽  
Semistructured Interview ◽  
Advanced Cancer Patients ◽  
Terminally Ill Cancer Patients ◽  
Symptom Intensity ◽  
Edmonton Symptom Assessment Scale ◽  
Desire To Die

AbstractObjective:We aimed to address the prevalence of desire-to-die statements (DDSs) among terminally ill cancer patients in an acute palliative care unit. We also intended to compare the underlying differences between those patients who make desire-to-die comments (DDCs) and those who make desire-for-euthanasia comments (EUCs).Method:We conducted a one-year cross-sectional prospective study in all patients receiving palliative care who had made a DDC or EUC. At inclusion, we evaluated symptom intensity, anxiety and depression, and conducted a semistructured interview regarding the reasons for these comments.Results:Of the 701 patients attended to during the study period, 69 (9.8%; IC95% 7.7–12.3) made a DDS: 51 (7.3%) a DDC, and 18 (2.5%) an EUC. Using Edmonton Symptom Assessment Scale (ESAS) DDC group showed higher percentage of moderate-severe symptoms (ESAS > 4) for well-being (91 vs. 25%; p = 0.001), depression (67 vs. 25%; p = 0.055), and anxiety (52 vs. 13%; p = 0.060) than EUC group. EUC patients also considered themselves less spiritual (44 vs. 84%; p = 0.034). The single most common reason for a DDS was pain or physical suffering, though most of the reasons given were nonphysical.Significance of results:Almost 10% of the population receiving specific oncological palliative care made a DDC (7.3%) or EUC (2.5%). The worst well-being score was lower in the EUC group. The reasons for both a DDC and EUC were mainly nonphysical. We find that emotional and spiritual issues should be identified and effectively addressed when responding to a DDS in terminally ill cancer patients.

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