Zvi Aminoff Bechor
Human Suffering and Satisfaction Research Center, El-Ad, Israel.
Am J Hosp Palliat Care. 2007;24(6):470-4. doi: 10.1177/1049909107302304. Epub 2007 Sep 21.
Six months of survival as a key criterion is extremely important for decision making in enrollment of critically ill patients to palliative settings. This was a prospective cohort study with 6 months of follow-up during a 24-month period performed in the Division of Geriatric Medicine in a tertiary general hospital. One-hundred three consecutively admitted, bedridden patients with end-stage dementia were evaluated. The Mini-Suffering State Examination scale was performed. Interrelations between the Mini-Suffering State Examination score at admission and 6-month survival and mortality were evaluated. A significant difference was proven among survival curves of subgroups of patients according to the mini scores (0-3, 4-6, 7-10). Survival was shorter and mortality higher in patients with a high Mini-Suffering State Examination score, as shown by the Kaplan-Meier method using the log rank (P=.001) and Breslow tests (P=.001). The Mini-Suffering State Examination scale is useful for predicting the last 6 months of survival and mortality of end-stage dementia patients.
六个月的生存期作为一项关键标准，对于决定将重症患者纳入姑息治疗环境极为重要。这是一项前瞻性队列研究，在一家三级综合医院的老年医学科进行，为期24个月，随访6个月。对103例连续收治的晚期痴呆卧床患者进行了评估。采用简易痛苦状态检查量表进行评估。评估入院时简易痛苦状态检查评分与6个月生存率和死亡率之间的相互关系。根据微小评分（0 - 3、4 - 6、7 - 10），患者亚组的生存曲线之间存在显著差异。使用对数秩检验（P = 0.001）和Breslow检验（P = 0.001）的Kaplan - Meier方法显示，简易痛苦状态检查评分高的患者生存期较短，死亡率较高。简易痛苦状态检查量表有助于预测晚期痴呆患者的最后6个月生存期和死亡率。
