Prognostic factors in inpatients with advanced cancer at a palliative care unit
Objectives: This study aims to identify prognostic factors and their discriminatory ability in inpatients with advanced cancer at a palliative care unit (PCU). Material and Methods: Observational, prospective cohort study involving advanced cancer patients (Octobe...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
2022-12-01
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| Series: | Brazilian Journal of Oncology |
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| Online Access: | https://www.brazilianjournalofoncology.com.br/details/222/en-US/prognostic-factors-in-inpatients-with-advanced-cancer-at-a-palliative-care-unit |
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| _version_ | 1849396934451658752 |
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| author | Karla Santos da Costa Rosa Amanda Soares Oliveira Raphael de Paiva Cypriano Livia Costa de Oliveira |
| author_facet | Karla Santos da Costa Rosa Amanda Soares Oliveira Raphael de Paiva Cypriano Livia Costa de Oliveira |
| author_sort | Karla Santos da Costa Rosa |
| collection | DOAJ |
| description | Objectives:
This study aims to identify prognostic factors and their discriminatory ability in inpatients with advanced cancer at a palliative care unit (PCU).
Material and Methods:
Observational, prospective cohort study involving advanced cancer patients (October 2019 to May 2021) of their first admission to a PCU. Sociodemographic, clinical, functional, nutritional, and laboratory variables were evaluated. The outcome was death within 30 days. Kaplan-Meier curves, log-rank test, and Cox proportional hazard model were used to assess prognostic value. The C-statistic was used to test the predictive accuracy of the variables.
Results:
Among 136 patients, 77 (56.6%) died within 30 days and the median overall survival was 10 (interquartile range: 6-14) days. The variables of 30-day mortality were tumor in the gastrointestinal tract (GIT) (hazard ratio [HR]: 1.61, 95% confidence interval [CI]: 1.11-2.82), impaired functionality (HR: 1.73, 95%CI: 1.09-3.00), nutritional risk (HR: 4.58, 95%CI: 1.62-12.92), and albumin <3g/dL (HR: 1.88, 95%CI: 1.05-3.34). However, albumin presented acceptable discrimination, with a C-statistic value of 0.75.
Conclusion:
Inpatients with advanced cancer in the GIT, impaired functionality, reduced serum albumin, and at nutritional risk have a worse prognosis. Albumin concentration has better discriminatory ability than the other factors identified. |
| format | Article |
| id | doaj-art-a99f9bbeac5049c3b7f0b1586ccb4e00 |
| institution | Kabale University |
| issn | 2526-8732 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Brazilian Journal of Oncology |
| spelling | doaj-art-a99f9bbeac5049c3b7f0b1586ccb4e002025-08-20T03:39:11ZengThieme Revinter Publicações Ltda.Brazilian Journal of Oncology2526-87322022-12-01180010.5935/2526-8732.20220344Prognostic factors in inpatients with advanced cancer at a palliative care unitKarla Santos da Costa Rosa0https://orcid.org/0000-0002-0951-8725Amanda Soares Oliveira1Raphael de Paiva Cypriano2Livia Costa de Oliveira3José Alencar Gomes da Silva National Cancer Institute (INCA), Palliative Care Unite - Rio de Janeiro - RJ - BrazilJosé Alencar Gomes da Silva National Cancer Institute (INCA), Palliative Care Unite - Rio de Janeiro - RJ - BrazilJosé Alencar Gomes da Silva National Cancer Institute (INCA), Palliative Care Unite - Rio de Janeiro - RJ - BrazilJosé Alencar Gomes da Silva National Cancer Institute (INCA), Palliative Care Unite - Rio de Janeiro - RJ - BrazilObjectives: This study aims to identify prognostic factors and their discriminatory ability in inpatients with advanced cancer at a palliative care unit (PCU). Material and Methods: Observational, prospective cohort study involving advanced cancer patients (October 2019 to May 2021) of their first admission to a PCU. Sociodemographic, clinical, functional, nutritional, and laboratory variables were evaluated. The outcome was death within 30 days. Kaplan-Meier curves, log-rank test, and Cox proportional hazard model were used to assess prognostic value. The C-statistic was used to test the predictive accuracy of the variables. Results: Among 136 patients, 77 (56.6%) died within 30 days and the median overall survival was 10 (interquartile range: 6-14) days. The variables of 30-day mortality were tumor in the gastrointestinal tract (GIT) (hazard ratio [HR]: 1.61, 95% confidence interval [CI]: 1.11-2.82), impaired functionality (HR: 1.73, 95%CI: 1.09-3.00), nutritional risk (HR: 4.58, 95%CI: 1.62-12.92), and albumin <3g/dL (HR: 1.88, 95%CI: 1.05-3.34). However, albumin presented acceptable discrimination, with a C-statistic value of 0.75. Conclusion: Inpatients with advanced cancer in the GIT, impaired functionality, reduced serum albumin, and at nutritional risk have a worse prognosis. Albumin concentration has better discriminatory ability than the other factors identified.https://www.brazilianjournalofoncology.com.br/details/222/en-US/prognostic-factors-in-inpatients-with-advanced-cancer-at-a-palliative-care-unitneoplasmspalliative careprognosishospitalizationmortality |
| spellingShingle | Karla Santos da Costa Rosa Amanda Soares Oliveira Raphael de Paiva Cypriano Livia Costa de Oliveira Prognostic factors in inpatients with advanced cancer at a palliative care unit Brazilian Journal of Oncology neoplasms palliative care prognosis hospitalization mortality |
| title | Prognostic factors in inpatients with advanced cancer at a palliative care unit |
| title_full | Prognostic factors in inpatients with advanced cancer at a palliative care unit |
| title_fullStr | Prognostic factors in inpatients with advanced cancer at a palliative care unit |
| title_full_unstemmed | Prognostic factors in inpatients with advanced cancer at a palliative care unit |
| title_short | Prognostic factors in inpatients with advanced cancer at a palliative care unit |
| title_sort | prognostic factors in inpatients with advanced cancer at a palliative care unit |
| topic | neoplasms palliative care prognosis hospitalization mortality |
| url | https://www.brazilianjournalofoncology.com.br/details/222/en-US/prognostic-factors-in-inpatients-with-advanced-cancer-at-a-palliative-care-unit |
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