[Clinical impressions of terminal cancer patients as an estimator of time of survival].
OBJECTIVE
To evaluate the relationship between the prognosis of the survival time of terminal cancer patients by doctors and nurses belonging to a Home Care Support Team (HCST) and the actual time of survival found. The first assessment and the last before death were examined.


METHODS
Prospective, descriptive study.


METHODS
Area 7 of primary care, Madrid.


METHODS
Were terminal cancer patients attended by the HCST between February 2001 and August 2002.


METHODS
Age, sex, location of the tumour, presence of metastasis, number and location of metastases, real survival time and the time estimated by the doctor and nurse at the first assessment and at the last before death. The quotient of survival time found/survival time estimated was calculated. If it was between 0.67 and 1.33, the prediction was considered correct; < 0.67, optimistic, and >1.33, pessimistic.


RESULTS
121 patients were studied, 57% men, with an average age of 72 +/- 12.8 years. At the first assessment, 30% of doctors' predictions were correct, 40% optimistic and 30% pessimistic. Of nurses' predictions, 40% were correct, 30% optimistic and 30% pessimistic. The intra-class correlation coefficients (ICC) between real and estimated survival times were 0.64 for doctors and 0.54 for nurses. At the final assessment, doctors had 38% correct predictions, 44% optimistic and 18% pessimistic; and nurses had 44% correct, 32% optimistic and 24% pessimistic. The ICCs were 0.83 and 0.84.


CONCLUSIONS
The accuracy of professionals' clinical impression was only acceptable at the moment of quantifying the prognosis.
Garrido Elustondo
S
S
Especialista en Medicina Preventiva, Gerencia de Atención Primaria, Area 7, Madrid, Spain.
de Miguel Sánchez
C
C
Vicente Sánchez
F
F
Cabrera Vélez
R
R
Macé Gutiérrez
I
I
Riestra Fernández
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011446:Prospective Studies; D015996:Survival Rate; D013727:Terminal Care; D013997:Time Factors