Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Tambon Sriphum, Muang District, Chiang Mai, 50200, Thailand.
Karunruk Palliative Care Center, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, 123 Mittraphap Road, Tambon Nai-Muang, Muang District, Khon Kaen, 40002, Thailand.
BMC Palliat Care. 2023 Jan 6;22(1):3. doi: 10.1186/s12904-023-01127-2.
Pneumonia in cancer patients is often problematic in order to decide whether to admit and administer antibiotics or pursue a comfort care pathway that may avoid in-hospital death. We aimed to identify factors which are easily assessed at admission in Thailand's healthcare context that could serve as prognostic factors for in-hospital death.
Regression analysis was utilized to identify the prognostic factors from clinical factors collected at admission. The primary outcome was in-hospital death. Data was collected from the electronic medical records of Chiang Mai University Hospital, Thailand, from 2016 to 2017. Data on adult cancer patients admitted due to pneumonia were reviewed.
In total, 245 patients were included, and 146 (59.6%) were male. The median age of the patients was 66 years (IQR: 57-75). A total of 72 (29.4%) patients died during admission. From multivariate logistic regression, prognostic factors for in-hospital death included: Palliative Performance Scale (PPS) ≤ 30 (OR: 8.47, 95% CI: 3.47-20.66), Palliative Performance Scale 40-50% (OR: 2.79, 95% CI: 1.34-5.81), percentage of lymphocytes ≤ 8.0% (OR: 2.10, 95% CI: 1.08-4.08), and pulse oximetry ≤ 90% (OR: 2.01, 95% CI: 1.04-3.87).
The in-hospital death rate of cancer patients admitted with pneumonia was approximately 30%. The PPS of 10-30%, PPS of 40-50%, percentage of lymphocytes ≤ 8%, and oxygen saturation < 90% could serve as prognostic factors for in-hospital death. Further prospective studies are needed to investigate the usefulness of these factors.
癌症患者的肺炎往往是一个问题，需要决定是否住院并使用抗生素，还是采取舒适护理途径，以避免院内死亡。我们旨在确定在泰国医疗保健环境中易于在入院时评估的因素，这些因素可作为院内死亡的预后因素。
利用回归分析从入院时收集的临床因素中确定预后因素。主要结局为院内死亡。数据来自 2016 年至 2017 年泰国清迈大学医院的电子病历。回顾了因肺炎入院的成年癌症患者的数据。
共纳入 245 例患者，其中 146 例（59.6%）为男性。患者的中位年龄为 66 岁（IQR：57-75）。共有 72 例（29.4%）患者在住院期间死亡。多变量逻辑回归显示，院内死亡的预后因素包括：姑息治疗表现量表（PPS）≤30（OR：8.47，95%CI：3.47-20.66），PPS 40-50%（OR：2.79，95%CI：1.34-5.81），淋巴细胞百分比≤8.0%（OR：2.10，95%CI：1.08-4.08），和脉搏血氧饱和度≤90%（OR：2.01，95%CI：1.04-3.87）。
因肺炎住院的癌症患者的院内死亡率约为 30%。PPS 为 10-30%、PPS 为 40-50%、淋巴细胞百分比≤8%和血氧饱和度<90%可作为院内死亡的预后因素。需要进一步的前瞻性研究来探讨这些因素的实用性。
