1 Department of Clinical Pharmacy Research and Education, School of Pharmaceutical Sciences, Osaka University Graduate, Osaka, Japan.
2 Department of Pharmacy and Ashiya Municipal Hospital, Hyogo, Japan.
J Palliat Med. 2019 Jun;22(6):685-690. doi: 10.1089/jpm.2018.0422. Epub 2019 Jan 14.
There is no established method to objectively predict short-term prognosis. Recently, we proposed objective, short-term, prognostic predictive methods that are combinations of laboratory test items: WPCBAL score, derived from six values (white blood cell, platelet, C-reactive protein, blood urea nitrogen, aspartate aminotransferase, and lactate dehydrogenase). However, that study was conducted in an acute-phase hospital to identify the test items useful for prognostic prediction; thus, whether WPCBAL score could be applied to terminal cancer patients in a palliative care unit was unverified. To verify the usefulness of WPCBAL score for terminal cancer patients. A retrospective study. Patients admitted to the palliative care unit of Ashiya Municipal Hospital ( = 128) in Japan in 2016. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the receiver operating characteristic curve (AUROC) were compared between WPCBAL score and the Glasgow prognostic score (GPS). For predicting three-week prognosis, WPCBAL score showed higher AUROC compared with GPS (0.7540 and 0.6573, respectively). WPCBAL score predicting two-week prognosis showed greater AUROC than GPS predicting three-week prognosis (0.7491 and 0.6573, respectively). WPCBAL score was verified to objectively predict the two- or three-week prognosis for terminal cancer patients in a palliative care unit. WPCBAL score may be a new option for prognostic prediction for terminal cancer patients.
目前尚无确定的方法能够客观地预测短期预后。最近,我们提出了一种客观的、短期的预后预测方法,该方法是由 6 项实验室检测项目(白细胞、血小板、C 反应蛋白、血尿素氮、天门冬氨酸氨基转移酶和乳酸脱氢酶)组合而成的 WPCBAL 评分。然而,该研究是在急性医院进行的,旨在确定对预后预测有用的检测项目;因此,WPCBAL 评分是否可应用于姑息治疗病房的终末期癌症患者尚未得到验证。
为了验证 WPCBAL 评分在终末期癌症患者中的应用价值,我们进行了一项回顾性研究。该研究纳入了 2016 年在日本芦屋市立医院姑息治疗病房就诊的 128 例患者。比较了 WPCBAL 评分和格拉斯哥预后评分(GPS)在预测 3 周预后方面的敏感性、特异性、阳性预测值、阴性预测值、准确性和受试者工作特征曲线下面积(AUROC)。在预测 3 周预后方面,WPCBAL 评分的 AUROC 高于 GPS(分别为 0.7540 和 0.6573)。在预测 2 周预后方面,WPCBAL 评分的 AUROC 也高于 GPS 预测 3 周预后的 AUROC(分别为 0.7491 和 0.6573)。
WPCBAL 评分被证实可客观预测姑息治疗病房终末期癌症患者的 2 或 3 周预后。WPCBAL 评分可能成为终末期癌症患者预后预测的一种新选择。