癌末病患短期存活的預測因子

Predicting Factors of Short-term Survival in Patients with Terminal Cancers

高以信(Yee-Hsin Guo) ； 劉鎮嘉(Chen-Chia Lui) ； 鄭宇翔(Yu-Hsiang Cheng) ； 江瑞坤(Jui-Kun Chiang) ； 王美華(Mei-Huang Wang) ； 陳世琦(Shi-Chi Chen) ； 賴育民(Yu-Min Lai)

《台灣醫學》 11卷2期 (2007/03) Pp. 153-161

https://doi.org/10.6320/FJM.2007.11(2).04

摘要

This issue that the survival time left behind for the terminal cancer patients is the major concern of the patients, families, and the hospice-care team. Up to date, many medical researches have paid their attention to prognostic scale of terminal cancer patients in hospice, but most of them base on patient's symptoms and signs. Our study focused on the observation of the routine lab data while they admitted, and found out the prognostic factors within 7 days. After improved survival prediction in terminal cancer patients, we can deliver more satisfactory care. A total of 375 consecutive patients admitted to the hospice ward at our hospital between November 2004 and November 2005. There were 311(84%) patients enrolled in our study and were followed until their death. The criteria to admit patients were followed by the law of hospice and palliative care in our country. We apply t test, chi-square test to compare the descriptive data, and logistic regression to test odds ratio of prognostic factors in patients within 7 days. In our study, the mean length of stay is 12±8 days, and the median survival time during admission is 14 days. There were 27.8% of patients who died within 7 days. We extracted four survival prognostic factors: SGOT(OR: 1.773, =0.0338), albumin (OR: 1.905, p=0.0465), BUN(OR: 4.188, p=＜0.0001), and WBC(OR: 1.915, p value: 0.0201). Four survival prognostic factors with statistical significance are found in our study. The state of hypoalbuminemia means cachexia of patients; abnormal SGOT represents abnormal liver function and may be resulted from involvement of other vital organs; the elevation of BUN induced terminal azotemia reveals that dehydration and GI tract bleeding is correlated; the abnormality of WBC may imply patients are in states of infection and/or carcinomatosis. We hope to promote the quality of the hospice care through our study.

關鍵字

安寧緩和 ； 癌末 ； 預後

並列摘要

This issue that the survival time left behind for the terminal cancer patients is the major concern of the patients, families, and the hospice-care team. Up to date, many medical researches have paid their attention to prognostic scale of terminal cancer patients in hospice, but most of them base on patient's symptoms and signs. Our study focused on the observation of the routine lab data while they admitted, and found out the prognostic factors within 7 days. After improved survival prediction in terminal cancer patients, we can deliver more satisfactory care. A total of 375 consecutive patients admitted to the hospice ward at our hospital between November 2004 and November 2005. There were 311(84%) patients enrolled in our study and were followed until their death. The criteria to admit patients were followed by the law of hospice and palliative care in our country. We apply t test, chi-square test to compare the descriptive data, and logistic regression to test odds ratio of prognostic factors in patients within 7 days. In our study, the mean length of stay is 12±8 days, and the median survival time during admission is 14 days. There were 27.8% of patients who died within 7 days. We extracted four survival prognostic factors: SGOT(OR: 1.773, =0.0338), albumin (OR: 1.905, p=0.0465), BUN(OR: 4.188, p=＜0.0001), and WBC(OR: 1.915, p value: 0.0201). Four survival prognostic factors with statistical significance are found in our study. The state of hypoalbuminemia means cachexia of patients; abnormal SGOT represents abnormal liver function and may be resulted from involvement of other vital organs; the elevation of BUN induced terminal azotemia reveals that dehydration and GI tract bleeding is correlated; the abnormality of WBC may imply patients are in states of infection and/or carcinomatosis. We hope to promote the quality of the hospice care through our study.

並列關鍵字

terminal ； hospice ； prognostic factor