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KMID : 0882420110810030359
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Korean Journal of Medicine
2011 Volume.81 No. 3 p.359 ~ p.365
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Survival Prediction in Terminally Ill Cancer Patients: Laboratory Variables and Prospective Validation of The Palliative Prognostic Index
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Son Hyo-Rim
Kim Dae-Eun
Kang Hyun-Wook
Kim Ha-Na
Yoon Ju-Young
Hwang Jun-Eul
Shim Hyun-Jeong
Cho Sang-Hee
Chung Ik-Joo
Bae Woo-Kyun
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Abstract
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Background/Aims : The palliative prognostic index (PPI) was designed to predict life expectancy based on clinical symptoms. In this study, a PPI was constructed and used with other biological parameters to predict 3-week survival in patients with advanced cancer.
Methods: The study included 222 patients. The PPI was constructed with five variables (performance status, oral intake, edema, dyspnea at rest, and delirium). PPI scores were grouped as follows: 4 (group 1); > 4 and ≤ 6 (group 2); and > 6 (group 3). At admission, seven biological variables (white blood cell count, lymphocyte, C-reactive protein [CRP], bilirubin, albumin, creatinine, and lactate dehydrogenase) were measured.
Results: The overall survival duration was 50 days in group 1, 22 days in group 2, and 14 days in groups 3. Using the PPI, a survival of < 3 weeks in group 3 was predicted with a sensitivity of 76.5% and a specificity of 65.4%. The important factors significantly affecting the 3-week survival rate were a PPI score > 6 and increases in serum bilirubin and CRP levels. Furthermore, the 3-week survival rate in patients with hepatopancreatobiliary cancer was more accurately predicted using a combination of the PPI, CRP, and serum bilirubin levels.
Conclusions: Although a PPI has limitations, it can be quickly applied to determine survival duration in patients admitted to hospice and accurately predicts 3-week survival. Furthermore, bilirubin and CRP are useful factors for predicting 3-week survival in patients with gastrointestinal cancer, including hepatopancreatobiliary cancer.
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KEYWORD
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Hospice Care, Survival Analysis, Bilirubin
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