Survival Prediction for Terminal Cancer Patients: A Preliminary Study

緩和醫療病房癌末病人之存活預估－初步研究

莊榮彬(Rong-Bin Chuang) ； 邱泰源(Wen-Yu Hu) ； 陳慶餘(Tai-Yuan Chiu) ； 胡文鬱(Ching-Yu Chen)

《安寧療護雜誌》 8卷1期 (2003/02) Pp. 1-12

https://doi.org/10.6537/TJHPC.2003.8(1).1

摘要

為了改善對癌末病人存活期預估之準确性，并提供末期病人妥適的醫療照顧，從事安寧緩和醫療的醫師需要較可靠的存活預估依據。本研究希望從病人之基本資料，癌症原發部位及轉移部位，入院之主要問題中，找出可供預估病人存活期之因子。本研究針對民國八十四年六月至民國八十五年五月間住院之癌末病人以病歷回顧方式進行研究。以單變數及多變數廻歸來檢驗各因子與存活期之關系．多變數廻歸之最後模式中顯示可供預估存活之因子為呼吸困難、昏迷、厭食、吞嚥困難、腹水及潰瘍傷口　。性別、年齡、癌症原發部位及轉移部位在此最後模式中顯示與癌末病人之存活期無明顯之關系。

並列摘要

Background and purpose: In order to provide appropriate care for terminal cancer patients, palliative care professionals require reliable prognostic criteria. The purpose of this study was to identify significant prognostic factors for survival in terminal cancer patients.
Methods: Chart review was conducted for the 214 consecutive terminal cancer patients (lO8males, 106 females; age range: 8~97 years old) admitted to the palliative care unit at National Taiwan University Hospital between June 1995 and May 1996. Univariate log-rank test and multiple Cox regression analysis were used to examine the relationship among demographic data, initial symptoms/signs and the survival of patients.
Results: The median survival for all patients was 18 days. Significant predictors for survial were confusion (hazard ratio HR: 2.04, 95% CI: 1.36-3.05), anorexia (HR: 1.90, 95% CI: 1.30-2.77), dyspnea (HR: 1.74, 95% CI: 1.28-2.36), ascites (HR: 1.49, 95% CI: 1.08-2.07), ulcerated wounds (HR: 1.48, 95% CI: 1.01-2.17), and dysphagia (HR: 1.46, 95% CI: 1.01- 2.15), which were independent of patient characteristics, primary cancer sites, and metastatic sites.
Conclusions: A combination of initial symptoms/signs might be used for survival prediction in terminal cancer patients.

並列關鍵字

prediction ； survival ； terminal cancer patients ； palliative care