Hu Xinyu, Chen Yang, Zhang Chuan, Jiang Jianjun, Xu Xin, Shao Meiying
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, P. R. China.
Department of Palliative Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, P. R. China.
BMC Palliat Care. 2024 Dec 2;23(1):276. doi: 10.1186/s12904-024-01607-z.
Predicting the survival time of patients at the end of life can provide more accurate treatment and care programs for patients. The purpose of this study was to investigate the factors impacting 14-day survival at the end of life.
This was a retrospective study. Patients with advanced cancer admitted to the Department of Palliative Medicine in a tertiary hospital in China in 2021 were included and classified into group A (survival time ≤ 14 days) or group B (survival time > 14 days). Patient demographic characteristics, palliative performance scale (PPS) scores, Barthel index scores, Fracture Risk Assessment Scale (FRAIL) scale scores, clinical features and laboratory test results were extracted from medical records. Univariable and multivariable logistic regression analyses were used to identify predictors of death within 14 days. Survival time was compared between frail and nonfrail patients.
A total of 261 patients were included (122 in group A and 139 in group B), with a median survival time of 17 (13.04, 20.96) days. There were significant differences in age, FRAIL score, PPS, Barthel index, dyspnea, edema, C-reactive protein and white blood cell count between the two groups. According to the multivariable logistic regression analysis, the PPS could predict the risk of death within 14 days (OR = 6.818, 95% CI = 3.944-11.785, p < 0.001). The median survival time was 48 (33.71, 62.29) days in the nonfrail group (n = 34) and 15 (12.46, 17.54) days in the frail group (n = 227) (p < 0.001).
A lower PPS increases the risk of 14-day mortality in patients at the end of life. Frailty may shorten the survival time of patients at the end of life.
预测临终患者的生存时间可为患者提供更精准的治疗和护理方案。本研究旨在探讨影响临终患者14天生存的因素。
这是一项回顾性研究。纳入2021年在中国一家三级医院姑息医学科住院的晚期癌症患者，并分为A组（生存时间≤14天）或B组（生存时间>14天）。从病历中提取患者的人口统计学特征、姑息治疗表现量表（PPS）评分、巴氏指数评分、衰弱风险评估量表（FRAIL）评分、临床特征和实验室检查结果。采用单因素和多因素逻辑回归分析确定14天内死亡的预测因素。比较衰弱和非衰弱患者的生存时间。
共纳入261例患者（A组122例，B组139例），中位生存时间为17（13.04，20.96）天。两组在年龄、FRAIL评分、PPS、巴氏指数、呼吸困难、水肿、C反应蛋白和白细胞计数方面存在显著差异。根据多因素逻辑回归分析，PPS可预测14天内的死亡风险（OR = 6.818，95%CI = 3.944 - 11.785，p < 0.001）。非衰弱组（n = 34）的中位生存时间为48（33.71，62.29）天，衰弱组（n = 227）为15（12.46，17.54）天（p < 0.001）。
较低的PPS会增加临终患者14天死亡的风险。衰弱可能会缩短临终患者的生存时间。
