TY - JOUR
T1 - Prognostic evaluation in palliative care
T2 - final results from a prospective cohort study
AU - Ermacora, Paola
AU - Mazzer, Micol
AU - Isola, Miriam
AU - Pascoletti, Gaetano
AU - Gregoraci, Giorgia
AU - Basile, Debora
AU - De Carlo, Elisa
AU - Merlo, Valentina
AU - Luz, Osorio
AU - Cattaruzza, Monica
AU - Orlando, Antonio
AU - Bozza, Claudia
AU - Pella, Nicoletta
AU - Sacco, Cosimo Stanislao
AU - Puglisi, Fabio
AU - Fasola, Gianpiero
AU - Aprile, Giuseppe
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Prognostic characterization in the initial assessment of patients with advanced cancer disease is an essential step to plan the most appropriate therapeutic program. Since clinical prediction of survival (CPS) may be of limited value, some authors have tried to integrate specific prognostic factors into prognostic multidimensional scores. We carried out a prospective cohort study in two palliative care units to compare the accuracy of the Palliative Prognostic (PaP) Score, the Objective Prognostic Score (OPS), and the Palliative Prognostic Index (PPI). In addition, we compared the accuracy of the CPS independently estimated by different healthcare professionals and we tested the role of laboratory results, together with clinical and social factors in predicting survival. Clinical and laboratory data of 334 advanced cancer patients were prospectively collected from the time of in-hospital admission. PaP Score was the most accurate index of survival prediction, followed by PPI; CPS estimates’ accuracy was similar among physicians and nurse. All healthcare professionals tended to underestimate the real survival. Integrating CPS with multidimensional indexes may further improve the patient’s management. The degree of autonomy and the number of metastatic sites were independent prognostic factors for 30-days mortality and overall survival in multivariate analysis.
AB - Prognostic characterization in the initial assessment of patients with advanced cancer disease is an essential step to plan the most appropriate therapeutic program. Since clinical prediction of survival (CPS) may be of limited value, some authors have tried to integrate specific prognostic factors into prognostic multidimensional scores. We carried out a prospective cohort study in two palliative care units to compare the accuracy of the Palliative Prognostic (PaP) Score, the Objective Prognostic Score (OPS), and the Palliative Prognostic Index (PPI). In addition, we compared the accuracy of the CPS independently estimated by different healthcare professionals and we tested the role of laboratory results, together with clinical and social factors in predicting survival. Clinical and laboratory data of 334 advanced cancer patients were prospectively collected from the time of in-hospital admission. PaP Score was the most accurate index of survival prediction, followed by PPI; CPS estimates’ accuracy was similar among physicians and nurse. All healthcare professionals tended to underestimate the real survival. Integrating CPS with multidimensional indexes may further improve the patient’s management. The degree of autonomy and the number of metastatic sites were independent prognostic factors for 30-days mortality and overall survival in multivariate analysis.
KW - Clinical prediction of survival
KW - Palliative care
KW - PaP Score
KW - Prognostic score
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U2 - 10.1007/s00520-018-4463-z
DO - 10.1007/s00520-018-4463-z
M3 - Article
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
SN - 0941-4355
ER -