title: Validation of the Cochin Risk Index Score (CRIS) for life expectancy prediction in terminally ill cancer patients.
abstract: BACKGROUND
  Oncologists often overestimate survival of advanced cancer patients. This study aimed to validate a score for survival prediction in terminally ill cancer patients.
  
  
  METHODS
  Between 2004 and 2008, a prospective study was performed in 500 consecutive advanced cancer patients referred to a palliative care unit. Evaluation at admission included physical examination and routine blood tests. On a randomly selected training set, independent factors assessable at inclusion predicting 2-week survival by a multiple logistic regression were assigned integer-rounded weights to develop a risk index score, which was tested on a validation set.
  
  
  RESULTS
  On the training set (334 patients), predictive factors were: urea >12 mmol/L (weight = 5, odds ratio (OR) = 3.72, 95% confidence interval (95%CI) = [1.59; 8.71], p = 0.002), Karnofsky Performance Status ≤30% (weight = 4, OR = 3.28, 95%CI = [1.80; 6.01], p < 0.001), leucocytes >15 g/L (weight = 3, OR = 2.49, 95%CI = [1.18; 5.25], p = 0.017), transthyretin ≤0.05 g/L (weight = 3, OR = 2.42, 95%CI = [1.16; 5.04], p = 0.019) and male gender (weight = 2, OR = 2.25, 95%CI = [1.28; 3.97], p = 0.005). On the validation set (166 patients), the Cochin Risk Index Score (CRIS) ≥ 7 identified high-risk patients, with a positive predictive value of 78%.
  
  
  CONCLUSIONS
  We validated the CRIS for survival prediction in terminally ill cancer patients.
authors.affiliation: Department of Medical Oncology, University Hospital Cochin, Université Paris Descartes, Assistance Publique–Hôpitaux de Paris, 27, Rue du Faubourg Saint Jacques, 75014 Paris, France. jean-philippe.durand@cch.aphp.fr
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Durand
authors.forename: Olivier
authors.initials: O
authors.lastname: Mir
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.forename: Anatole
authors.initials: A
authors.lastname: Cessot
authors.forename: Sylvain
authors.initials: S
authors.lastname: Pourchet
authors.forename: François
authors.initials: F
authors.lastname: Goldwasser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008017:Life Expectancy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology*; D010166:Palliative Care / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D019452:Terminally Ill; D055815:Young Adult