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    ABSTRACT: Abstract Background: The Palliative Performance Scale (PPS) is a tool that is widely used to predict end of life. In Ontario, Canada, the PPS is used to mark the terminal phase of life and eligibility for terminal care. Objective: The aim of this retrospective study was to confirm that a PPS level of 40% can be used as a marker for the terminal phase of life. Method: PPS levels from 78 patients were calculated based on the intake reports made at admission to an inpatient hospice. Results: Although 77 patients passed away within a period of 3 months, PPS levels at admission varied from 10% to 70%. Fifty-six percent of all patients had a PPS level of 40% or less. Regarding survival, three significant PPS profiles, consisting of two or more PPS levels could be distinguished.
    Journal of Palliative Medicine 08/2014; DOI:10.1089/jpm.2013.0645 · 2.06 Impact Factor
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    ABSTRACT: Abstract Background: Accurate prediction of prognosis for cancer patients is important for good clinical decision making in therapeutic and care strategies. The application of prognostic tools and indicators could improve prediction accuracy. Objective: This study aimed to develop a new prognostic scale to predict survival time of advanced cancer patients in China. Methods: We prospectively collected items that we anticipated might influence survival time of advanced cancer patients. Participants were recruited from 12 hospitals in Shanghai, China. We collected data including demographic information, clinical symptoms and signs, and biochemical test results. Log-rank tests, Cox regression, and linear regression were performed to develop a prognostic scale. Results: Three hundred twenty patients with advanced cancer were recruited. Fourteen prognostic factors were included in the prognostic scale: Karnofsky Performance Scale (KPS) score, pain, ascites, hydrothorax, edema, delirium, cachexia, white blood cell (WBC) count, hemoglobin, sodium, total bilirubin, direct bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) values. The score was calculated by summing the partial scores, ranging from 0 to 30. When using the cutoff points of 7-day, 30-day, 90-day, and 180-day survival time, the scores were calculated as 12, 10, 8, and 6, respectively. Conclusions: We propose a new prognostic scale including KPS, pain, ascites, hydrothorax, edema, delirium, cachexia, WBC count, hemoglobin, sodium, total bilirubin, direct bilirubin, AST, and ALP values, which may help guide physicians in predicting the likely survival time of cancer patients more accurately. More studies are needed to validate this scale in the future.
    Journal of palliative medicine 04/2014; 17(5). DOI:10.1089/jpm.2013.0368 · 2.06 Impact Factor
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    ABSTRACT: The purpose of this study is to develop and validate a scale prognostic of survival in hospitalized, terminally ill cancer patients in China. Terminally ill cancer patients hospitalized at two general hospitals in China were prospectively analyzed. Patients were divided into a training cohort (n = 181) and a testing cohort (n = 128). Factors prognostic of survival were identified in the training cohort and combined into a scale, which was validated in the testing cohort. In the training cohort, eight factors associated with reduced survival were identified: low performance status, dyspnea at rest, reduced oral intake, cognitive impairment, edema, leukocytosis, and elevated urea and alanine transaminase concentrations. A prognostic prediction score was calculated for each patient, based on the weight of these eight predictors in the regression model, with scores ranging from 0 (no altered variables) to 12 (maximal altered variables). Patients with different prognostic scores had significantly different prognoses (p < 0.001). A cutoff point of ≥4 was optimal in categorizing patients with "low" (score <4) and "high" (score ≥4) risk of survival for less than 30 days, with median survival time in these groups of 47 and 9 days, respectively. Using this cutoff point on the testing cohort, median survival time for the low and high risk groups were 66 and 11 days, respectively. 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.
    Supportive Care in Cancer 09/2013; 22(1). DOI:10.1007/s00520-013-1970-9 · 2.50 Impact Factor


Available from
May 22, 2014