Rees E, Hardy J, Ling J, Broadley K, A'Hern R
Department of Palliative Medicine, Royal Marsden NHS Trust, London, UK.
Palliat Med. 1998 Mar;12(2):75-82. doi: 10.1191/026921698674135173.
The Edmonton Symptom Assessment scale (ESAS) was used on 1004 occasions to assess 71 patients with advanced malignant disease admitted to a palliative care unit in the UK over a six-week period. The median length of inpatient stay was eight days (range 1-36) and the median survival from start of ESAS to death was 16 days (range 2-202). Across all patients there was a trend towards worsening symptom scores over the first five days from admission with a significant deterioration in appetite scores. When scores were analysed retrospectively over five days according to outcome (death--group 1, or discharge--group 2) there was a significant improvement in pain scores in group 2 but no change in overall score, and a significant deterioration in activity, drowsiness and appetite in group 1 with no change in overall score. ESAS did not seem an appropriate tool in this group of patients as the total symptom scores were so often biased by the inevitable increase in individual symptom scores immediately prior to death.
在六周时间里，埃德蒙顿症状评估量表（ESAS）被用于1004次，以评估英国一家姑息治疗病房收治的71例晚期恶性疾病患者。住院时间中位数为8天（范围1 - 36天），从开始使用ESAS到死亡的中位生存期为16天（范围2 - 202天）。在所有患者中，入院后的头五天症状评分有恶化趋势，食欲评分显著下降。当根据结局（死亡——第1组，或出院——第2组）对五天内的评分进行回顾性分析时，第2组的疼痛评分有显著改善，但总分无变化，第1组的活动、嗜睡和食欲评分显著恶化，总分也无变化。在这组患者中，ESAS似乎不是一个合适的工具，因为总症状评分常常因死亡前个体症状评分不可避免的增加而有偏差。
