title: Objective palliative prognostic score among patients with advanced cancer.
abstract: BACKGROUND
  The accurate prediction of survival is one of the key factors in the decision-making process for patients with advanced illnesses.
  
  
  OBJECTIVE
  This study aimed to develop a short-term prognostic prediction method that included such objective factors as medical history, vital signs, and blood tests for use with patients with advanced cancer.
  
  
  METHODS
  Medical records gathered at the admission of patients with advanced cancer to the hospice palliative care unit at a tertiary hospital in Taiwan were reviewed retrospectively. The records included demographics, history of cancer treatments, performance status, vital signs, and biological parameters, Multivariate logistic regression analyses and receiver operating characteristic curves were used for model development.
  
  
  RESULTS
  The Objective Palliative Prognostic Score was determined by using six objective predictors identified by multivariate logistic regression analysis. The predictors include heart rate >120/min, white blood cells >11,000/mm(3), platelets <130,000/mm(3), serum creatinine level >1.3 mg/dL, serum potassium level >5 mg/dL, and no history of chemotherapy. The area under the receiver operating characteristic curve used to predict seven-day survival was 82.0% (95% confidence interval 75.2%-88.8%). If any three predictors of the six were reached, death within seven days was predicted with 68.8% sensitivity, 86.0% specificity, 55.9% positive predictive value, and 91.4% negative predictive value.
  
  
  CONCLUSIONS
  The Objective Palliative Prognostic Score consists of six objective predictors for the estimation of seven-day survival among patients with advanced cancer and showed a relatively high accuracy, specificity, and negative predictive value. Objective signs, such as vital signs and blood test results, may help clinicians make decisions at the end of life.
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Yen-Ting
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chih-Te
authors.initials: CT
authors.lastname: Ho
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Hua-Shai
authors.initials: HS
authors.lastname: Hsu
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Po-Tsung
authors.initials: PT
authors.lastname: Huang
authors.affiliation: Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chin-Yu
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors.forename: Chiu-Shong
authors.initials: CS
authors.lastname: Liu
authors.affiliation: Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan; Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan.
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan.
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Hospice Palliative Medicine Unit, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: wylin@mail.cmu.edu.tw.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Lin
mesh_terms: D019540:Area Under Curve; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D010166:Palliative Care / Q000379:methods*; D011188:Potassium / Q000097:blood; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D062606:Tertiary Care Centers
chemical_list: D003404:Creatinine; D011188:Potassium
keywords: Advanced cancer; objective; palliative care; prediction; prognosis; survival