title: Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study.
abstract: OBJECTIVE
  The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors.
  
  
  METHODS
  A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated.
  
  
  RESULTS
  The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%.
  
  
  CONCLUSIONS
  We developed the new OPS, without clinician's survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).
authors.affiliation: Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea.
authors.forename: Sang-Yeon
authors.initials: SY
authors.lastname: Suh
authors.forename: Youn Seon
authors.initials: YS
authors.lastname: Choi
authors.forename: Jae Yong
authors.initials: JY
authors.lastname: Shim
authors.forename: Young Sung
authors.initials: YS
authors.lastname: Kim
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Yeom
authors.forename: Daeyoung
authors.initials: D
authors.lastname: Kim
authors.forename: Shin Ae
authors.initials: SA
authors.lastname: Park
authors.forename: Sooa
authors.initials: S
authors.lastname: Kim
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Seo
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Daegyeun
authors.initials: D
authors.lastname: Kim
authors.forename: Sung-Eun
authors.initials: SE
authors.lastname: Choi
authors.forename: Hong-Yup
authors.initials: HY
authors.lastname: Ahn
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000855:Anorexia / Q000453:epidemiology; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D004417:Dyspnea / Q000453:epidemiology; D004435:Eating; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007964:Leukocytosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000401:mortality*; D010166:Palliative Care / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate; D013727:Terminal Care / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D001663:Bilirubin