Hosoi Takahiro, Ozone Sachiko, Hamano Jun
Faculty of Medicine Division of Clinical Medicine Department of General Medicine University of Tsukuba Tsukuba Ibaraki Japan.
Faculty of Medicine Kamisu Clinical Education and Training Center University of Tsukuba Kamisu Ibaraki Japan.
J Gen Fam Med. 2019 Dec 6;21(2):9-14. doi: 10.1002/jgf2.290. eCollection 2020 Mar.
The prediction of short-term survival is important for noncancer patients and their families. Although a markedly reduced oral intake by cancer patients suggests a poor prognosis, the survival times of noncancer patients after its onset remain unclear. We herein investigated the time from a marked reduction in oral intake to death in noncancer patients as well as factors associated with their subsequent survival.
We conducted a retrospective medical record review of noncancer patients who died in our hospital between April 2017 and April 2018. We recorded the day when oral intake markedly decreased and the date of death. We extracted data on age, gender, the Charlson Comorbidities Index, mean daily fluid volume, laboratory test results, and vital signs converted to the Shock Index (SI). We used Cox's proportional hazards models to assess relationships between these factors and survival times after the onset of a markedly reduced oral intake.
We analyzed data from 44 noncancer patients. The median time from the onset of a markedly reduced oral intake to death was 16.5 days. Based on Cox's proportional hazards models, only SI ≧ 1.0 at the onset of a markedly reduced oral intake correlated with survival times (hazard ratio: 5.89, 95% confidence interval (CI): 1.71-20.1, = .005).
Noncancer patients died a median of 16.5 days after the onset of a markedly reduced oral intake, and SI ≧1.0 correlated with subsequent survival times. These results will provide novel insights into the prognosis of noncancer patients at the end of life.
短期生存预测对非癌症患者及其家属而言至关重要。尽管癌症患者口服摄入量显著减少预示预后不良,但非癌症患者出现这种情况后的生存时间仍不明确。我们在此研究了非癌症患者从口服摄入量显著减少到死亡的时间,以及与其后续生存相关的因素。
我们对2017年4月至2018年4月期间在我院死亡的非癌症患者进行了回顾性病历审查。我们记录了口服摄入量显著减少的日期和死亡日期。我们提取了年龄、性别、查尔森合并症指数、平均每日液体量、实验室检查结果以及转换为休克指数(SI)的生命体征数据。我们使用Cox比例风险模型来评估这些因素与口服摄入量显著减少后生存时间之间的关系。
我们分析了44例非癌症患者的数据。从口服摄入量显著减少到死亡的中位时间为16.5天。基于Cox比例风险模型,仅口服摄入量显著减少开始时SI≧1.0与生存时间相关(风险比:5.89,95%置信区间(CI):1.71 - 20.1,P = 0.005)。
非癌症患者在口服摄入量显著减少后中位16.5天死亡,且SI≧1.0与后续生存时间相关。这些结果将为临终非癌症患者的预后提供新的见解。