[终末期癌症患者的临床印象作为生存时间的估计指标]

[Clinical impressions of terminal cancer patients as an estimator of time of survival].

作者信息

Garrido Elustondo S, de Miguel Sánchez C, Vicente Sánchez F, Cabrera Vélez R, Macé Gutiérrez I, Riestra Fernández A

机构信息

Especialista en Medicina Preventiva, Gerencia de Atención Primaria, Area 7, Madrid, Spain.

出版信息

Aten Primaria. 2004 Jun 30;34(2):75-80. doi: 10.1016/s0212-6567(04)79463-9.

DOI:10.1016/s0212-6567(04)79463-9

PMID:15225528

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7668960/

Abstract

OBJECTIVE

To evaluate the relationship between the prognosis of the survival time of terminal cancer patients by doctors and nurses belonging to a Home Care Support Team (HCST) and the actual time of survival found. The first assessment and the last before death were examined.

DESIGN

Prospective, descriptive study.

SETTING

Area 7 of primary care, Madrid.

PARTICIPANTS

Were terminal cancer patients attended by the HCST between February 2001 and August 2002.

MAIN MEASUREMENTS

Age, sex, location of the tumour, presence of metastasis, number and location of metastases, real survival time and the time estimated by the doctor and nurse at the first assessment and at the last before death. The quotient of survival time found/survival time estimated was calculated. If it was between 0.67 and 1.33, the prediction was considered correct; < 0.67, optimistic, and >1.33, pessimistic.

RESULTS

121 patients were studied, 57% men, with an average age of 72 +/- 12.8 years. At the first assessment, 30% of doctors' predictions were correct, 40% optimistic and 30% pessimistic. Of nurses' predictions, 40% were correct, 30% optimistic and 30% pessimistic. The intra-class correlation coefficients (ICC) between real and estimated survival times were 0.64 for doctors and 0.54 for nurses. At the final assessment, doctors had 38% correct predictions, 44% optimistic and 18% pessimistic; and nurses had 44% correct, 32% optimistic and 24% pessimistic. The ICCs were 0.83 and 0.84.

CONCLUSIONS

The accuracy of professionals' clinical impression was only acceptable at the moment of quantifying the prognosis.

摘要

目的

评估家庭护理支持团队（HCST）的医生和护士对晚期癌症患者生存时间的预后判断与实际生存时间之间的关系。研究首次评估和死亡前最后一次评估的情况。

设计

前瞻性描述性研究。

地点

马德里初级保健第7区。

参与者

2001年2月至2002年8月期间由HCST护理的晚期癌症患者。

主要测量指标

年龄、性别、肿瘤位置、转移情况、转移灶数量和位置、实际生存时间以及医生和护士在首次评估和死亡前最后一次评估时估计的时间。计算实际生存时间/估计生存时间的商。如果该商在0.67至1.33之间，则预测被认为是正确的；<0.67为乐观，>1.33为悲观。

结果

共研究了121例患者，男性占57%，平均年龄为72±12.8岁。在首次评估时，医生的预测30%正确，40%乐观，30%悲观。护士的预测中，40%正确，30%乐观，30%悲观。实际生存时间与估计生存时间之间的组内相关系数（ICC），医生为0.64，护士为0.54。在最后评估时，医生的预测38%正确，44%乐观，18%悲观；护士则为44%正确，32%乐观，24%悲观。ICC分别为0.83和0.84。