Combination of Initial Palliative Prognostic Index and Score Change Provides a Better Prognostic Value for Terminally Ill Cancer Patients: A Six-Year.

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Presentation transcript:

Combination of Initial Palliative Prognostic Index and Score Change Provides a Better Prognostic Value for Terminally Ill Cancer Patients: A Six-Year Observational Cohort Study Chen-Yi Kao, MD, Yu-Shin Hung, MD, Hung-Ming Wang, MD, Jen-Shi Chen, MD, Tsu-Ling Chin, RN, Ching-Yi Lu, RN, Chuan-Chuan Chi, RN, Ya-Chi Yeh, RN, Jin-Mei Yang, RN, Jung-Hsuan Yen, RN, Wen-Chi Chou, MD Journal of Pain and Symptom Management Volume 48, Issue 5, Pages 804-814 (November 2014) DOI: 10.1016/j.jpainsymman.2013.12.246 Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 1 Study flowchart. PPI = Palliative Prognostic Index. Journal of Pain and Symptom Management 2014 48, 804-814DOI: (10.1016/j.jpainsymman.2013.12.246) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 2 a) Median survival for patients in the good (score, zero to two), intermittent (score, 2.5 to four), and poor (score, more than four) prognostic groups according to the initial PPI categories (red: good prognostic group; yellow: intermittent group; and green: poor prognostic group). b) Subgroup survival analysis of patients with score changes (Δscore) in different prognostic groups according to the initial PPI categories (red: good prognostic group; yellow: intermittent group; green: poor prognostic group; solid line: Δscore = 0; fine dashed line: Δscore > 0; and coarse dashed line: Δscore < 0). HR = hazard ratio. Journal of Pain and Symptom Management 2014 48, 804-814DOI: (10.1016/j.jpainsymman.2013.12.246) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 3 The c-statistic at the best cutoff point among the initial PPI, Week 1, score change (Δscore), and combined initial PPI and Δscore for predictions of life expectancy <30 days (upper and lower ends of the columns represent the 95% CIs for each c-statistic). ∗A significant difference in the c-statistic compared with the combined initial PPI and Δscore; P < 0.001. PPI = Palliative Prognostic Index. Journal of Pain and Symptom Management 2014 48, 804-814DOI: (10.1016/j.jpainsymman.2013.12.246) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 4 Receiver operating characteristic curves of predicted life expectancies <30 days according to the initial PPI (solid line) and combined initial PPI and Δscore (dotted line) categories. PPI = Palliative Prognostic Index. Journal of Pain and Symptom Management 2014 48, 804-814DOI: (10.1016/j.jpainsymman.2013.12.246) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions