预测即将死亡的癌症患者的第二天生存率:一个多中心队列研究
Masanori Mori1, Takuhiro Yamaguchi2, Isseki Maeda3
1Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Journal of palliative medicine
|February 10, 2025
概括
在即将死亡的癌症患者中,准确预测第二天的存活率至关重要. 开发了三种模型 (P1d-生存-DT,器官系统得分,早期症状),以帮助临终决策的患者的息性表现量 (PPS) ≤20.
科学领域:
- 抚慰性护理医学 抚慰性护理医学
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 准确预测第二天的存活率对于即将死亡的患者的终身护理决策至关重要.
- 息性绩效尺度 (PPS) ≤20表示需要预后工具的危急状态.
- 现有的预后模型可能无法充分捕捉晚期癌症即将死亡的细微差别.
研究的目的:
- 开发和验证诊断模型,用于预测晚期癌症患者的第二天存活率,其PPS得分≤20.
- 评估决策树模型 (P1d-Survival-DT),器官系统评分模型和早期症状模型的有效性.
主要方法:
- 一项多中心,前性,观察性研究,涉及1896名在日本23个息护理单位的晚期癌症患者.
- 每天记录临床迹象即将死亡的PPS ≤20患者,直到死亡或长达14天.
- 开发了三种预测模型:P1d-生存-DT,P1d-生存-器官系统得分,以及早期迹象模型.
主要成果:
- 根据P1d-Survival-DT模型,根据特定的临床症状,显示出不同的生存率 (例如,91.6%与37.1%).
- 器官系统得分模型显示,得分0的生存率为95.9%,得分4的生存率降至46.7%.
- 早期症状模型预测,正常意识且没有液体消化不良的患者的存活率为95.2%.
结论:
- 成功开发了三种不同的模型,用于预测PPS ≤20的癌症患者的第二天存活率.
- 这些模型为临床医生提供了有价值的工具,以促进及时和明智的终生决策.
- 进一步将这些模型纳入临床实践可以提高息护理的质量.
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