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- Title
A 2-week prognostic prediction model for terminal cancer patients in a palliative care unit at a Japanese general hospital.
- Authors
Ohde, Sachiko; Hayashi, Akitoshi; Takahasi, Osamu; Yamakawa, Sen; Nakamura, Megumi; Osawa, Ayako; Shapiro, Mina L; Deshpande, Gautam A; Tokuda, Yasuharu; Omata, Fumio; Ishida, Yasushi; Soejima, Kumiko; Hinohara, Shigeaki; Fukui, Tsuguya
- Abstract
Objective: We aimed to develop a prognostic prediction model for 2-week survival among patients with terminal cancer in a palliative care unit (PCU).Methods: A prospective cohort study was conducted on terminal cancer patients in the PCU for 11 months at a general hospital in Tokyo, Japan. We collected data regarding demographics, treatment history, performance status, symptoms, and laboratory results. Patients who survived more than 2 weeks were labeled ‘long survivors’ and those who died within 2 weeks were grouped as ‘short survivors’. Stepwise logistic regression model was constructed for the model development and bootstrapping was used for the internal model validation.Results: In 158 subjects whose data were available for the analysis, 109 (69%) subjects were categorized as long survivors and 49 (31%) subjects as short survivors. A prognostic prediction model with a total score of 8 points was constructed as follows: 2 points each for anorexia, dyspnea, and edema; 1 point each for blood urea nitrogen >25 mg/dl and platelets <260,000/mm3. Area under the receiver operating characteristic (ROC) curve of this model was 83.2% (95% CI: 75.3—91.0%). Bootstrapped validation beta coefficients of the predictors were similar to the original cohort beta coefficients.Conclusion: Our prognostic prediction model for estimating 14-day survival for patients with terminal cancer on the PCU ward included five clinical predictors that are readily available in the clinical setting and showed a relatively high accuracy. External validation is needed to confirm the model’s generalizability.
- Subjects
JAPAN; HOSPITAL admission &; discharge; PATIENTS; BLOOD testing; CANCER patients; DEMOGRAPHY; HOSPITALS; KIDNEY function tests; LONGITUDINAL method; MATHEMATICAL models; RESEARCH methodology; EVALUATION of medical care; MEDICAL needs assessment; PALLIATIVE treatment; STATISTICS; TERMINALLY ill; LOGISTIC regression analysis; DATA analysis; RECEIVER operating characteristic curves
- Publication
Palliative Medicine, 2011, Vol 25, Issue 2, p170
- ISSN
0269-2163
- Publication type
Article
- DOI
10.1177/0269216310383741