1 School of Nursing, Second Military Medical University , Shanghai, China .
J Palliat Med. 2014 May;17(5):545-52. doi: 10.1089/jpm.2013.0368. Epub 2014 Apr 7.
Accurate prediction of prognosis for cancer patients is important for good clinical decision making in therapeutic and care strategies. The application of prognostic tools and indicators could improve prediction accuracy.
This study aimed to develop a new prognostic scale to predict survival time of advanced cancer patients in China.
We prospectively collected items that we anticipated might influence survival time of advanced cancer patients. Participants were recruited from 12 hospitals in Shanghai, China. We collected data including demographic information, clinical symptoms and signs, and biochemical test results. Log-rank tests, Cox regression, and linear regression were performed to develop a prognostic scale.
Three hundred twenty patients with advanced cancer were recruited. Fourteen prognostic factors were included in the prognostic scale: Karnofsky Performance Scale (KPS) score, pain, ascites, hydrothorax, edema, delirium, cachexia, white blood cell (WBC) count, hemoglobin, sodium, total bilirubin, direct bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) values. The score was calculated by summing the partial scores, ranging from 0 to 30. When using the cutoff points of 7-day, 30-day, 90-day, and 180-day survival time, the scores were calculated as 12, 10, 8, and 6, respectively.
We propose a new prognostic scale including KPS, pain, ascites, hydrothorax, edema, delirium, cachexia, WBC count, hemoglobin, sodium, total bilirubin, direct bilirubin, AST, and ALP values, which may help guide physicians in predicting the likely survival time of cancer patients more accurately. More studies are needed to validate this scale in the future.
准确预测癌症患者的预后对于治疗和护理策略的临床决策至关重要。应用预后工具和指标可以提高预测准确性。
本研究旨在开发一种新的预后评分系统，以预测中国晚期癌症患者的生存时间。
我们前瞻性地收集了我们预计可能影响晚期癌症患者生存时间的项目。参与者来自中国上海的 12 家医院。我们收集的数据包括人口统计学信息、临床症状和体征以及生化检查结果。采用对数秩检验、Cox 回归和线性回归来开发预后评分系统。
共纳入 320 例晚期癌症患者。预后评分系统纳入了 14 个预后因素：卡氏功能状态评分（KPS）、疼痛、腹水、胸水、水肿、意识模糊、恶病质、白细胞计数、血红蛋白、钠、总胆红素、直接胆红素、天冬氨酸转氨酶（AST）和碱性磷酸酶（ALP）值。评分通过累加各部分得分计算，得分范围为 0 至 30。当使用 7 天、30 天、90 天和 180 天生存时间的截断点时，评分分别计算为 12、10、8 和 6。
我们提出了一种新的预后评分系统，包括 KPS、疼痛、腹水、胸水、水肿、意识模糊、恶病质、白细胞计数、血红蛋白、钠、总胆红素、直接胆红素、AST 和 ALP 值，这可能有助于医生更准确地预测癌症患者的预期生存时间。未来需要更多的研究来验证该评分系统。
