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在中国的居家舒缓治疗环境中,验证舒缓预后指数、基于活动状态的舒缓预后指数和中国预后量表在晚期癌症患者中的应用。

Validation of the Palliative Prognostic Index, Performance Status-Based Palliative Prognostic Index and Chinese Prognostic Scale in a home palliative care setting for patients with advanced cancer in China.

机构信息

Department of Spine Surgery, Yuebei People's Hospital Affiliated to Shantou University Medical College, Shaoguan, Guangdong, China.

Department of Nursing, Yuebei People's Hospital Affiliated to Shantou University Medical College, Shaoguan, Guangdong, China.

出版信息

BMC Palliat Care. 2020 Oct 31;19(1):167. doi: 10.1186/s12904-020-00676-0.

Abstract

BACKGROUND

The predictive value of the prognostic tool for patients with advanced cancer is uncertain in mainland China, especially in the home-based palliative care (HPC) setting. This study aimed to compare the accuracy of the Palliative Prognostic Index (PPI), the Performance Status-Based Palliative Prognostic Index (PS-PPI), and the Chinese Prognosis Scale (ChPS) for patients with advanced cancer in the HPC setting in mainland China.

METHODS

Patients with advanced cancer admitted to the hospice center of Yuebei People's Hospital between January 2014 and December 2018 were retrospectively calculated the scores according to the three prognostic tools. The Kaplan-Meier method was used to compare survival times among different risk groups. Receiver operating characteristic curve analysis was used to assess the predictive value. The accuracy of 21-, 42- and 90-day survival was compared among the three prognostic tools.

RESULTS

A total of 1863 patients were included. Survival time among the risk groups of all prognostic tools was significantly different from each other except for the PPI. The AUROC of the ChPS was significantly higher than that of the PPI and PS-PPI for 7-, 14, 21-, 42-, 90-, 120-, 150- and 180-day survival (P < 0.05). The AUROC of the PPI and PS-PPI were not significantly different from each other (P > 0.05).

CONCLUSIONS

The ChPS is more suitable than the PPI and PS-PPI for advanced cancer patients in the HPC setting. More researches are needed to verify the predictive value of the ChPS, PPI, and PS-PPI in the HPC setting in the future.

摘要

背景

在中国大陆,特别是在居家舒缓治疗(HPC)环境下,预测工具对晚期癌症患者的预测价值尚不确定。本研究旨在比较姑息预后指数(PPI)、基于表现状态的姑息预后指数(PS-PPI)和中国预后量表(ChPS)在中国大陆 HPC 环境下对晚期癌症患者的准确性。

方法

回顾性地根据三种预后工具,计算了 2014 年 1 月至 2018 年 12 月间入住粤北人民医院临终关怀中心的晚期癌症患者的分数。Kaplan-Meier 法用于比较不同风险组的生存时间。接受者操作特征曲线分析用于评估预测价值。比较了三种预后工具的 21 天、42 天和 90 天生存率的准确性。

结果

共纳入 1863 例患者。除 PPI 外,所有预后工具的风险组之间的生存时间均有显著差异。ChPS 的 AUROC 在 7、14、21、42、90、120、150 和 180 天生存方面明显高于 PPI 和 PS-PPI(P<0.05)。PPI 和 PS-PPI 的 AUROC 之间无显著差异(P>0.05)。

结论

ChPS 比 PPI 和 PS-PPI 更适合 HPC 环境下的晚期癌症患者。未来需要更多的研究来验证 ChPS、PPI 和 PS-PPI 在 HPC 环境下的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9da/7603699/83ceb5e7a514/12904_2020_676_Fig1_HTML.jpg

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