OBJECTIVE: This study evaluated the prognostic abilities of Palliative Prognostic Index (PPI), Laboratory Prognostic Score (LPS), and Palliative Prognostic Score (PaP).
METHODS: We included 989 terminally ill patients with cancer who consulted for admission to our palliative care unit. We compared the discriminative abilities of PPI, LPS, and PaP for 7-, 14-, 30-, 60-, and 90-day mortality. Additionally, we compared the estimated median survival of PPI, LPS, and PaP with the actual survival (AS). The prediction accuracy was considered adequate if the ratio of estimated median survival in days to AS in days fell within the range of 0.66 to 1.33, optimistic when it exceeds 1.33, and pessimistic when it falls below 0.66.
RESULTS: The accuracies for 7-, 14-, 30-, 60-, and 90-day mortality were superior for PPI, LPS, LPS, PaP, and PaP (72%, 73%, 71%, 80%, and 82%), respectively, although the discriminative abilities for 7-, 14-, 30-, 60-, and 90-day mortality were similar among the three scoring systems. The prediction accuracy of survival (PAS) was similar among the three scoring systems with adequate, optimistic, and pessimistic rates of 36%-41%, 20%-46%, and 16%-38%, respectively. PAS was superior in actual survival for 14-59 days.
CONCLUSIONS: The prognostic abilities of PPI, LPS, and PaP were comparable. The most adequate estimation occurred for patients with AS for 14-59 days. A more accurate prognostic model is needed for patients with longer survival.
目的:本研究评估姑息性预后指数(PPI)的预后能力,实验室预后评分(LPS),姑息性预后评分(PaP)。
方法:我们纳入了989名接受姑息治疗的绝症癌症患者。我们比较了PPI的判别能力,LPS,和PaP为7-,14-,30-,60-,90天死亡率。此外,我们比较了PPI的估计中位生存期,LPS,和PaP与实际生存(AS)。如果估计的中位生存期天数与AS天数的比率在0.66至1.33的范围内,当超过1.33时乐观,当低于0.66时悲观,则认为预测准确性足够。
结果:7-,14-,30-,60-,90天死亡率优于PPI,LPS,LPS,PaP,和PaP(72%,73%,71%,80%,和82%),分别,虽然7-的辨别能力,14-,30-,60-,三种评分系统的90日死亡率相似.在三个评分系统中,生存率(PAS)的预测精度相似,乐观,悲观率36-41%,20-46%,16-38%,分别。PAS在14-59天的实际存活中是优越的。
结论:PPI的预后能力,LPS,和PaP具有可比性。最适当的估计发生在14-59天的AS患者。对于生存期较长的患者,需要更准确的预后模型。