Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Palliat Med. 2011 Oct;25(7):682-90. doi: 10.1177/0269216311398301. Epub 2011 Apr 13.
To assess the significance of symptoms and their severity for predicting survival of hospitalized patients with far advanced cancer.
Two hundred fifty-six patients with far advanced cancer at the Cancer Center of Tongji Hospital, China were assessed by the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C). A Cox regression model was used to determine symptoms that could predict survival time. The log-rank test was used to compare the survival of patients accompanied by significant symptoms at different intensities.
Median survival was 49 days. Fatigue was the most common and severe symptom, followed by lack of appetite, disturbed sleep, and pain. Multivariate analysis showed that fatigue, shortness of breath, lack of appetite, and feeling sad were independent prognostic factors for survival time (p < 0.05), with a hazard ratio of dying of 1.39, 1.13, 1.33, and 1.16, respectively. The survival time for patients with different intensities of the four symptoms showed significant differences (p < 0.01).
Fatigue, lack of appetite, feeling sad, and shortness of breath could be predictive factors for survival time of hospitalized patients with far advanced cancer. The more severe these symptoms are, the shorter will be survival time.
评估症状及其严重程度对预测住院晚期癌症患者生存的意义。
采用中文版安德森症状评估量表（MDASI-C）对中国同济医院癌症中心的 256 例晚期癌症患者进行评估。采用 Cox 回归模型确定可预测生存时间的症状。采用对数秩检验比较不同严重程度伴随显著症状的患者的生存情况。
中位生存时间为 49 天。疲劳是最常见和最严重的症状，其次是食欲不振、睡眠障碍和疼痛。多变量分析显示，疲劳、呼吸困难、食欲不振和悲伤是生存时间的独立预后因素（p<0.05），死亡风险比分别为 1.39、1.13、1.33 和 1.16。四种症状不同严重程度的患者生存时间存在显著差异（p<0.01）。
疲劳、食欲不振、悲伤和呼吸困难可能是住院晚期癌症患者生存时间的预测因素。这些症状越严重，生存时间越短。
