Development and validation of a prognostic scale for hospitalized patients with terminally ill cancer in China

Abstract

We identified eight indicators predictive of poor survival in Chinese patients hospitalized with terminal cancer. A prognostic scale that includes these indicators may help in making decisions about end-of-life care.

Patient-reported symptoms and problems at admission to specialized palliative care improved survival prediction in 30,969 cancer patients: A nationwide register-based study

“…In palliative care teams, worse pain was associated with longer survival, whereas the opposite was observed in hospice. Most previous studies in patients referred to specialized palliative care did not find a significant association between pain and survival, 1,[25][26][27][28]30,31,[33][34][35]37,[44][45][46][47][49][50][51][52][53][54][55] but one study in patients with advanced cancer with short life expectancy (2-9 month) found worse pain to be associated with shorter survival time, 43 similar to our finding in hospice patients. The unexpected association between worse pain and longer survival in palliative care teams found in this study might be explained in the same way as with emotional function, that is, by early referral to specialized palliative care for pain control.…”

“…This is in accordance with three systematic reviews on survival prediction in cancer patients with expected survival of ⩽ 90 days. [16][17][18] Several previous studies of patients referred to specialized palliative care also found low physical function (activity of daily living, usual activities, mobility, performance score, self-care, physical function, or physical wellbeing), 1,[26][27][28]30,31,35,37,[42][43][44][45][46] problems related to eating/low or reduced weight (reduced appetite, early satiety, eating problems, dysphagia, and cachexia), 1,[25][26][27][28]30,31,[33][34][35][36][37][43][44][45]47,48 dyspnea, 1,26,28,31,[33][34][35]37,43,45,46,[48][49][50]…”

“…Some tools developed to predict survival time in advanced cancer patients included symptoms/problems (the Palliative Prognostic Index, the Palliative Prognostic Score, etc.). 17,25,[28][29][30][31][32][33][34][35][36][37] The symptom/problem measures were, however, often not self-reported and some not validated. Still, the tools may be used to supplement the doctor's prognostication.…”

“…Still, the tools may be used to supplement the doctor's prognostication. 17,25,[28][29][30][31][32][33][34][35][36][37] However, while the symptoms/problems were included in the tools because of their significant association with survival, it was often not tested whether the survival prediction was improved by including symptoms/problems in the tool.…”

Definitions for “palliative care”, “end-of-life” and “terminally ill” in oncology: a scoping review

“…Regarding countries, the following stands out Australia (10%), Canada (12%), South Korea (10%), United States (10%), Netherlands (8%), and Taiwan About the definitions: "end-of-life" was characterized in five studies, four quantitative and one qualitative; "palliative care" was defined in 15 studies, 11 quantitative and four qualitative and "terminally ill" appeared in 35 studies, 31 quantitative and five qualitative. (Appendix 1) (5,8,9,15,16,17,18,19,3,20,21,22,23,24,25,26,27,28,29,30,11,12,10,13,14,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,5...…”