Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study
Goals of work The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors. Materials and methods A multicenter study of 209 terminally ill cancer patients from six train...
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Veröffentlicht in: | Supportive care in cancer 2010-02, Vol.18 (2), p.151-157 |
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creator | Suh, Sang-Yeon Choi, Youn Seon Shim, Jae Yong Kim, Young Sung Yeom, Chang Hwan Kim, Daeyoung Park, Shin Ae Kim, Sooa Seo, Ji Yeon Kim, Su Hyun Kim, Daegyeun Choi, Sung-Eun Ahn, Hong-Yup |
description | Goals of work
The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors.
Materials and methods
A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated.
Main results
The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%.
Conclusions
We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set). |
doi_str_mv | 10.1007/s00520-009-0639-x |
format | Article |
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The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors.
Materials and methods
A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated.
Main results
The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%.
Conclusions
We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-009-0639-x</identifier><identifier>PMID: 19381691</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Activities of Daily Living ; Adult ; Aged ; Analysis ; Anorexia - epidemiology ; Bilirubin ; Bilirubin - blood ; Biomarkers - blood ; C-Reactive Protein - metabolism ; Cancer ; Cancer patients ; Care and treatment ; Cognition Disorders - epidemiology ; Comorbidity ; Creatinine - blood ; Dyspnea - epidemiology ; Eating ; Female ; Follow-Up Studies ; Humans ; L-Lactate Dehydrogenase - blood ; Leukocytosis - epidemiology ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasms - blood ; Neoplasms - mortality ; Nursing ; Nursing Research ; Oncology ; Oncology, Experimental ; Original Article ; Pain Medicine ; Palliative Care - statistics & numerical data ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Rehabilitation Medicine ; Republic of Korea - epidemiology ; Survival Rate ; Terminal Care - statistics & numerical data ; Terminal illnesses ; Terminally ill persons</subject><ispartof>Supportive care in cancer, 2010-02, Vol.18 (2), p.151-157</ispartof><rights>Springer-Verlag 2009</rights><rights>COPYRIGHT 2010 Springer</rights><rights>Springer-Verlag 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-d89c988ed8a5100b2d5034b0ef160afcd20d7486124993a4fd6fc4db37796c73</citedby><cites>FETCH-LOGICAL-c503t-d89c988ed8a5100b2d5034b0ef160afcd20d7486124993a4fd6fc4db37796c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-009-0639-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-009-0639-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19381691$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suh, Sang-Yeon</creatorcontrib><creatorcontrib>Choi, Youn Seon</creatorcontrib><creatorcontrib>Shim, Jae Yong</creatorcontrib><creatorcontrib>Kim, Young Sung</creatorcontrib><creatorcontrib>Yeom, Chang Hwan</creatorcontrib><creatorcontrib>Kim, Daeyoung</creatorcontrib><creatorcontrib>Park, Shin Ae</creatorcontrib><creatorcontrib>Kim, Sooa</creatorcontrib><creatorcontrib>Seo, Ji Yeon</creatorcontrib><creatorcontrib>Kim, Su Hyun</creatorcontrib><creatorcontrib>Kim, Daegyeun</creatorcontrib><creatorcontrib>Choi, Sung-Eun</creatorcontrib><creatorcontrib>Ahn, Hong-Yup</creatorcontrib><title>Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Goals of work
The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors.
Materials and methods
A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated.
Main results
The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%.
Conclusions
We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).</description><subject>Activities of Daily Living</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Anorexia - epidemiology</subject><subject>Bilirubin</subject><subject>Bilirubin - blood</subject><subject>Biomarkers - blood</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Cognition Disorders - epidemiology</subject><subject>Comorbidity</subject><subject>Creatinine - blood</subject><subject>Dyspnea - epidemiology</subject><subject>Eating</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>L-Lactate Dehydrogenase - blood</subject><subject>Leukocytosis - epidemiology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasms - blood</subject><subject>Neoplasms - mortality</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Palliative Care - statistics & numerical data</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Rehabilitation Medicine</subject><subject>Republic of Korea - epidemiology</subject><subject>Survival Rate</subject><subject>Terminal Care - statistics & numerical data</subject><subject>Terminal illnesses</subject><subject>Terminally ill persons</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUuPFCEUhYnROD2jP8CNIbqYjTVCQRWFu0nHVzKJm9kTikeHThW0QDnT_97bqU4mGg0LwuE7B24OQm8ouaGEiI-FkK4lDSGyIT2TzeMztKGcsUYwJp-jDZGcNpx13QW6LGVPCBWia1-iCyrZQHtJNyhsUyw1L6aGFHHyWOPoHj7gNO4daL8cPuS0i6nUYHAxKTvsU8bV5TlEPU1HHKYJGx2Ny_iga3Cxlk-QMi8TWOAEeqmLPb5CL7yeint93q_Q_ZfP99tvzd2Pr9-3t3eN6QirjR2kkcPg7KA7GHJsLch8JM7TnmhvbEus4ENPWy4l09zb3htuRyaE7I1gV-h6jYV__1xcqWoOxbhp0tGlpSjBeEsIowzId3-R-7RkGKqooZdcCjlwgN6v0E5PToXoU83anCLVLevgScG6Hqibf1CwrJuDSdH5APofBroaTE6lZOfVIYdZ56OiRJ26VWu3CrpVp27VI3jenv-7jLOzT45zmQC0K1DgKu5cfhro_6m_ASjyrsA</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>Suh, Sang-Yeon</creator><creator>Choi, Youn Seon</creator><creator>Shim, Jae Yong</creator><creator>Kim, Young Sung</creator><creator>Yeom, Chang Hwan</creator><creator>Kim, Daeyoung</creator><creator>Park, Shin Ae</creator><creator>Kim, Sooa</creator><creator>Seo, Ji Yeon</creator><creator>Kim, Su Hyun</creator><creator>Kim, Daegyeun</creator><creator>Choi, Sung-Eun</creator><creator>Ahn, Hong-Yup</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20100201</creationdate><title>Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study</title><author>Suh, Sang-Yeon ; Choi, Youn Seon ; Shim, Jae Yong ; Kim, Young Sung ; Yeom, Chang Hwan ; Kim, Daeyoung ; Park, Shin Ae ; Kim, Sooa ; Seo, Ji Yeon ; Kim, Su Hyun ; Kim, Daegyeun ; Choi, Sung-Eun ; Ahn, Hong-Yup</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-d89c988ed8a5100b2d5034b0ef160afcd20d7486124993a4fd6fc4db37796c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Activities of Daily Living</topic><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Anorexia - epidemiology</topic><topic>Bilirubin</topic><topic>Bilirubin - blood</topic><topic>Biomarkers - blood</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Cognition Disorders - epidemiology</topic><topic>Comorbidity</topic><topic>Creatinine - blood</topic><topic>Dyspnea - epidemiology</topic><topic>Eating</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>L-Lactate Dehydrogenase - blood</topic><topic>Leukocytosis - epidemiology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasms - blood</topic><topic>Neoplasms - mortality</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Palliative Care - statistics & numerical data</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Rehabilitation Medicine</topic><topic>Republic of Korea - epidemiology</topic><topic>Survival Rate</topic><topic>Terminal Care - statistics & numerical data</topic><topic>Terminal illnesses</topic><topic>Terminally ill persons</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suh, Sang-Yeon</creatorcontrib><creatorcontrib>Choi, Youn Seon</creatorcontrib><creatorcontrib>Shim, Jae Yong</creatorcontrib><creatorcontrib>Kim, Young Sung</creatorcontrib><creatorcontrib>Yeom, Chang Hwan</creatorcontrib><creatorcontrib>Kim, Daeyoung</creatorcontrib><creatorcontrib>Park, Shin Ae</creatorcontrib><creatorcontrib>Kim, Sooa</creatorcontrib><creatorcontrib>Seo, Ji Yeon</creatorcontrib><creatorcontrib>Kim, Su Hyun</creatorcontrib><creatorcontrib>Kim, Daegyeun</creatorcontrib><creatorcontrib>Choi, Sung-Eun</creatorcontrib><creatorcontrib>Ahn, Hong-Yup</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suh, Sang-Yeon</au><au>Choi, Youn Seon</au><au>Shim, Jae Yong</au><au>Kim, Young Sung</au><au>Yeom, Chang Hwan</au><au>Kim, Daeyoung</au><au>Park, Shin Ae</au><au>Kim, Sooa</au><au>Seo, Ji Yeon</au><au>Kim, Su Hyun</au><au>Kim, Daegyeun</au><au>Choi, Sung-Eun</au><au>Ahn, Hong-Yup</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>18</volume><issue>2</issue><spage>151</spage><epage>157</epage><pages>151-157</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Goals of work
The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors.
Materials and methods
A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated.
Main results
The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%.
Conclusions
We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>19381691</pmid><doi>10.1007/s00520-009-0639-x</doi><tpages>7</tpages></addata></record> |
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subjects | Activities of Daily Living Adult Aged Analysis Anorexia - epidemiology Bilirubin Bilirubin - blood Biomarkers - blood C-Reactive Protein - metabolism Cancer Cancer patients Care and treatment Cognition Disorders - epidemiology Comorbidity Creatinine - blood Dyspnea - epidemiology Eating Female Follow-Up Studies Humans L-Lactate Dehydrogenase - blood Leukocytosis - epidemiology Male Medical prognosis Medicine Medicine & Public Health Middle Aged Neoplasms - blood Neoplasms - mortality Nursing Nursing Research Oncology Oncology, Experimental Original Article Pain Medicine Palliative Care - statistics & numerical data Predictive Value of Tests Prognosis Proportional Hazards Models Prospective Studies Rehabilitation Medicine Republic of Korea - epidemiology Survival Rate Terminal Care - statistics & numerical data Terminal illnesses Terminally ill persons |
title | Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study |
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