Validation of the Simplified Palliative Prognostic Index to Predict Survival for Advanced Cancer Patients in Home Hospice Setting
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: The simplified Palliative Prognostic Index (sPPI) substitutes a single item from the Communication Capacity Scale (CCS) for the delirium item of the original PPI. This study aimed to examine the validity of the sPPI for patients with advanced cancer in a home-based hospice care setting. Methods: This study included 75 patients with advanced cancer who received home-based hospice care. We used medical records maintained by professional hospice nurses who had visited the patients in their homes. Based on their sPPI score, patients were divided into three groups—A (<4), B (≥4 and <6), and C (≥6)—to compare survival. Further, we investigated the sPPI’s accuracy using the area under the receiver operating characteristic curve (AUC) and sensitivity and specificity for 3- and 6-week survival. We used three sPPIs including different substitutions for the delirium item (two methods using the CCS and one using the Korean Nursing Delirium Screening Scale). Results: The median survival was 60–61 days for group A, 27–30 days for group B, and 12–16 days for group C. The difference in survival was significant (P<0.05). The AUC was 0.814–0.867 for 3-week survival and 0.736–0.779 for 6-week survival. For 3- and 6-week survival, prognostic prediction showed sensitivities of 76.2%–90.9% and 76.3%– 86.8%, and specificities of 64.2%–88.7% and 51.4%–70.3%, respectively. Conclusion: The sPPI, which is measured by professional hospice nurses, has acceptable validity to predict survival for patients with advanced cancer in a home hospice setting in South Korea.
Abstract
Background: The simplified Palliative Prognostic Index (sPPI) substitutes a single item from the Communication Capacity Scale (CCS) for the delirium item of the original PPI. This study aimed to examine the validity of the sPPI for patients with advanced cancer in a home-based hospice care setting. Methods: This study included 75 patients with advanced cancer who received home-based hospice care. We used medical records maintained by professional hospice nurses who had visited the patients in their homes. Based on their sPPI score, patients were divided into three groups—A (<4), B (≥4 and <6), and C (≥6)—to compare survival. Further, we investigated the sPPI’s accuracy using the area under the receiver operating characteristic curve (AUC) and sensitivity and specificity for 3- and 6-week survival. We used three sPPIs including different substitutions for the delirium item (two methods using the CCS and one using the Korean Nursing Delirium Screening Scale). Results: The median survival was 60–61 days for group A, 27–30 days for group B, and 12–16 days for group C. The difference in survival was significant (P<0.05). The AUC was 0.814–0.867 for 3-week survival and 0.736–0.779 for 6-week survival. For 3- and 6-week survival, prognostic prediction showed sensitivities of 76.2%–90.9% and 76.3%– 86.8%, and specificities of 64.2%–88.7% and 51.4%–70.3%, respectively. Conclusion: The sPPI, which is measured by professional hospice nurses, has acceptable validity to predict survival for patients with advanced cancer in a home hospice setting in South Korea.
참고문헌 (30)
- Steinhauser KE, "Preparing for the end of life: preferences of patients, families, physicians, and other care providers", J Pain Symptom Man-age, 22, pp.727~737 (2001)
- Christakis NA, "Attitude and self-reported practice regarding prognostication in a national sample of internists", Arch Intern Med, 158, pp.2389~2395 (1998)
- Rose JH, "Generalists and oncologists show similar care practices and outcomes for hospitalized late-stage cancer patients", Med Care, 38, pp.1103~1118 (2000)
- Lau F, "A systematic review of prognostic tools for estimating survival time in palliative care", J Palliat Care, 23, pp.93~112 (2007)
- Lau F, "Use of the Palliative Performance Scale(PPS)for end-of-life prognostication in a palliative medicine consultation service", J Pain Symptom Manage, 37, pp.965~972 (2009)
- Glare PA, "Diagnostic accuracy of the palliative prognostic score in hospitalized patients with advanced cancer", J Clin Oncol, 22, pp.4823~4828 (2004)
- Scarpi E, "Survival prediction for terminally ill cancer patients : revision of the palliative prognostic score with incorporation of delirium", Oncologist, 16, pp.1793~1799 (2011)
- Hyodo I, "Development of a predicting tool for survival of terminally ill cancer patients", Jpn J Clin Oncol, 40, pp.442~448 (2010)
- Gwilliam B, "Development of prognosis in palliative care study (PiPS) predictor models to improve prognostication in advanced cancer: prospective cohort study", BMJ, 343, pp.d4920~ (2011)
- Alshemmari S, "The palliative prognostic index for the prediction of survival and in-hospital mortality of patients with advanced cancer in Kuwait", J Palliat Med, 15, pp.200~204 (2012)
- Subramaniam S, "Accuracy of prognosis prediction by PPI in hospice inpatients with cancer : a multi-centre prospective study", BMJ Support Palliat Care, 3, pp.324~329 (2013)
- Stone CA, "Prospective validation of the palliative prognostic index in patients with cancer", J Pain Symptom Manage, 35, pp.617~622 (2008)
- Cheng WH, "Validation of a palliative prognostic index to predict life expectancy for terminally ill cancer patients in a hospice consultation setting in Taiwan", Asian Pac J Cancer Prev, 13, pp.2861~2866 (2012)
- Baba M, "Survival prediction for advanced cancer patients in the real world: a comparison of the Palliative Prognostic Score, Delirium-Palliative Prognostic Score, Palliative Prognostic Index and modified Prognosis in Palliative Care Study predictor model", Eur J Cancer, 51, pp.1618~1629 (2015)
- Morita T, "The Palliative Prognostic Index : a scoring system for survival prediction of terminally ill cancer patients", Support Care Cancer, 7, pp.128~133 (1999)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (1994), American Psychiatric Association
- Morita T, "Communication Capacity Scale and Agitation Distress Scale to measure the severity of delirium in terminally ill cancer patients : a validation study", Palliat Med, 15, pp.197~206 (2001)
- Hamano J, "Validation of the simplified palliative prognostic index using a single item from the Communication Capacity Scale", J Pain Symptom Manage, 50, pp.542~547 (2015)
- Hamano J, "Prospective clarification of the utility of the palliative prognostic index for patients with advanced cancer in the home care setting", Am J Hosp Palliat Care, 31, pp.820~824 (2014)
- 김경남, "한국어판 간호 섬망 선별 도구 개발 및 검증", Journal of Korean Academy of Nursing, 42(3), pp.414~423 (2012), 한국간호과학회
- Anderson F, "Palliative performance scale(PPS) : a new tool", J Palliat Care, 12, pp.5~11 (1996)
- Gaudreau JD, "Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale", J Pain Symptom Manage, 29, pp.368~375 (2005)
- Power M, "Principles for high-quality, high-value testing", Evid Based Med, 18, pp.5~10 (2013)
- Simundic AM, "Measures of diagnostic accuracy : basic definitions", EJIFCC, 19, pp.203~211 (2009)
- Choi KS, "Factors influencing preferences for place of terminal care and of death among cancer patients and their families in Korea", Support Care Cancer, 13, pp.565~572 (2005)
- Youn KH, "Change in hospital using pattern after palliative home care program", Korean J Fam Pract, 8, pp.386~390 (2018)
- Hargrave A, "Validation of a nurse-based delirium-screening tool for hospitalized patients", Psychosomatics, 58, pp.594~603 (2017)
- Gwilliam B, "Prognosticating in patients with advanced cancer : observational study comparing the accuracy of clinicians’ and patients’ estimates of survival", Ann Oncol, 24, pp.482~488 (2013)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
- Adamis D, "A comparison of outcomes according to different diagnostic systems for delirium (DSM-5, DSM-IV, CAM, and DRS-R98)", Int Psychogeriatr, 30, pp.591~596 (2018)