Predictors of survival in terminal-cancer patients with irreversible bowel obstruction receiving home parenteral nutrition.
Clinical, anthropometric, hematologic, and biochemical variables, evaluated immediately before starting nutritional treatment, were related to survival in 76 terminal-cancer patients with irreversible bowel obstruction receiving home parenteral nutrition. At baseline, abnormally low values were observed in the following percentages of patients: 40.8% for body mass index, 59.2% for serum albumin, 84.2% for hemoglobin, 48.7% for lymphocyte count, and 60% for serum cholesterol. Survival on home parenteral nutrition ranged between 6 and 301 d, with a median of 74 d. Hemoglobin, serum albumin and serum cholesterol were lower in patients with a survival of less than 3 mo. With regard to Karnofsky performance status, median survival times were 63 d for a score below or equal to 50 and 128 d for a score between 60 and 70. Albumin and a Karnofsky score above 50 (but not age, weight, body mass index, lymphocyte count, or cholesterol) emerged (with a positive sign) as predictors of survival. In conclusion, terminal-cancer patients with irreversible bowel obstruction are often malnourished, showing a high prevalence of anemia and hypoalbuminemia. Survival differs widely and can be predicted only to a limited extent from initial values of serum albumin and Karnofsky performance status.
Pasanisi
F
F
Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
Orban
A
A
Scalfi
L
L
Alfonsi
L
L
Santarpia
L
L
Zurlo
E
E
Celona
A
A
Potenza
A
A
Contaldo
F
F
D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications* / Q000628:therapy; D017567:Karnofsky Performance Status; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016331:Parenteral Nutrition, Home; D011237:Predictive Value of Tests; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D013727:Terminal Care; D019452:Terminally Ill; D016896:Treatment Outcome
D006454:Hemoglobins; D012709:Serum Albumin; D002784:Cholesterol