Yıl: 2021 Cilt: 6 Sayı: 1 Sayfa Aralığı: 49 - 55 Metin Dili: İngilizce DOI: 10.22391/fppc.752549 İndeks Tarihi: 19-04-2022

Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?

Öz:
Introduction: Palliative Performance Scale (PPS), Karnofsky Performance Scale (KPS) and the Edmonton Symptom Assessment Scale (ESAS) are widely used prognostic scales in palliative care unit. Institutionalized palliative care services in our country are quite new compared to the practices in many countries. We do not have concrete data on the compatibility of these scales, which are developed with patient data from other countries, in our own palliative care practices with real cases. In this study, we aimed to evaluate the convenience of the Turkish versions of these scales on the first days of hospitalization of terminal cancer patients who were followed up in the palliative clinic of our hospital. We also questioned whether the initial estimated survival and actual survival were compatible. Methods: PPS, KPS and ESAS on the first days of hospitalization of terminal cancer patients, hospitalized in the palliative clinic of our hospital between November 14, 2016 and November 14, 2017, were retrospectively evaluated one year later (n = 222). The survivors and those who lost their lives were determined. The survival estimates with PPS of the patients who died were compared with their actual survival. Results: The average age of 222 patients (18% female, 82% male) participating in the study was 64.49 ± 11.62, and the range was 26-91. PPS, KPS, ESAS were determined as a mean value of 34.40±18.00 (min. 10-max. 90), 32.90±17.50 (min. 10-max. 90), 56.10±15.65 (min. 2-max. 90), respectively. The AUC of PPS is 0.83 (p<0.001) and the AUC of KPS is 0.78 (p<0.001) suggesting that KPS and PPS has at least one tie between alive and dead patients, which is 45%. Median survival time was found 14.00, 95% C.I. [10.87–17.13]. Conclusion: In our study, it was found that as the KPS and PPS scores decrease, the survival time of terminal cancer patients decrease. Patients with PPS <45% had a higher risk of death (sensitivity 71%, specificity 80%), patients with KPS <45% had a higher risk of death (sensitivity 60%, specificity 81%), and patients with ESAS> 60.50 had a higher risk of death (sensitivity 93%, specificity 45%). PPS is a useful assessment scale for predicting survival of terminal cancer patients in the palliative care unit. We think it is important in determining our patient-specific palliative approach and treatments
Anahtar Kelime:

Kanser hastalarında sağkalım Palyatif Performans Skalası ile doğru olarak tahmin edilebilir mi?

Öz:
Giriş: Palyatif Performans Ölçeği (PPS), Karnofsky Performans Ölçeği (KPS) ve Edmonton Semptom Değerlendirme Ölçeği (ESAS), palyatif bakım servislerinde yaygın olarak kullanılan prognostik ölçeklerdir. Ülkemizde kurumsallaşmış palyatif bakım hizmetleri birçok ülkedeki uygulamalara göre oldukça yenidir. Başka ülkelerdeki hasta verileriyle geliştirilen bu skalaların kendi palyatif bakım uygulamalarımızda oluşturduğu tahminlerin gerçek yaşamla uygunluğu konusunda somutlaşmış verilere sahip değiliz. Bu çalışmamızda, hastanemiz palyatif kliniğinde takip edilen terminal dönem kanser hastalarının ilk yatış günlerinde, bu ölçeklerin Türkçe versiyonlarının uygunluğunu değerlendirmeyi amaçladık. Ayrıca başlangıçtaki tahmini sağkalımla gerçek sağkalımın uygun olup olmadığını sorguladık. Yöntem: 14 Kasım 2016 ile 14 Kasım 2017 tarihleri arasında hastanemiz palyatif kliniğinde yatan terminal kanser olgularının ilk yatış günlerindeki PPS, KPS ve ESAS, bir yıl sonra retrospektif olarak değerlendirildi (n=222). Hayatta kalanlar ve hayatını kaybedenler belirlendi. Ölen hastaların PPS ile yapılan sağkalım tahminleri gerçek sağkalımlarıyla karşılaştırıldı. Bulgular: Çalışmaya katılan 222 hastanın (%18 kadın, %82 erkek) yaşlarının ortalaması 64.49±11.62, aralığı ise 26-91’di. PPS ortalama değeri 34,40 ± 18,00 (min. 10-maks. 90), KPS 32,90 ± 17,50 (min. 10-maks. 90), ESAS 56,10±15,65 (min. 2-maks. 90) olarak saptandı. PPS için AUC değeri 0,83 (p <0,001), KPS için ise 0,78 (p <0,001) olarak hesaplandı ve %45 eşik değerine ulaşıldı. Medyan sağkalım süresi 14 gün (95% C.I. [10.87–17.13]) olarak bulundu. Sonuç: Çalışmamızda KPS ve PPS skorları düştükçe terminal kanser hastalarının sağkalım sürelerinin azaldığı saptandı. PPS <%45 olan hastalarda ölüm riski daha yüksek bulundu (duyarlılık %71, özgüllük %80), KPS <%45 olan hastalarda ölüm riski daha yüksek bulundu (duyarlılık %60, özgüllük %81) ve ESAS >60.50 olan hastalarda ölüm riski daha yüksek bulundu (duyarlılık %93, özgüllük %45). PPS, palyatif bakım ünitesinde terminal kanser hastalarının sağkalım tahmininde kullanışlı bir değerlendirme ölçeğidir. Hastaya özgü palyatif yaklaşım ve tedavilerimizin belirlenmesinde önemli olduğunu düşünüyoruz.
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APA Aras G, Seçik Arkın F, DOGU E (2021). Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. , 49 - 55. 10.22391/fppc.752549
Chicago Aras Gülfidan,Seçik Arkın Funda,DOGU ELIF Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. (2021): 49 - 55. 10.22391/fppc.752549
MLA Aras Gülfidan,Seçik Arkın Funda,DOGU ELIF Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. , 2021, ss.49 - 55. 10.22391/fppc.752549
AMA Aras G,Seçik Arkın F,DOGU E Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. . 2021; 49 - 55. 10.22391/fppc.752549
Vancouver Aras G,Seçik Arkın F,DOGU E Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. . 2021; 49 - 55. 10.22391/fppc.752549
IEEE Aras G,Seçik Arkın F,DOGU E "Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?." , ss.49 - 55, 2021. 10.22391/fppc.752549
ISNAD Aras, Gülfidan vd. "Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?". (2021), 49-55. https://doi.org/10.22391/fppc.752549
APA Aras G, Seçik Arkın F, DOGU E (2021). Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. Aile Hekimliği ve Palyatif Bakım, 6(1), 49 - 55. 10.22391/fppc.752549
Chicago Aras Gülfidan,Seçik Arkın Funda,DOGU ELIF Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. Aile Hekimliği ve Palyatif Bakım 6, no.1 (2021): 49 - 55. 10.22391/fppc.752549
MLA Aras Gülfidan,Seçik Arkın Funda,DOGU ELIF Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. Aile Hekimliği ve Palyatif Bakım, vol.6, no.1, 2021, ss.49 - 55. 10.22391/fppc.752549
AMA Aras G,Seçik Arkın F,DOGU E Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. Aile Hekimliği ve Palyatif Bakım. 2021; 6(1): 49 - 55. 10.22391/fppc.752549
Vancouver Aras G,Seçik Arkın F,DOGU E Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?. Aile Hekimliği ve Palyatif Bakım. 2021; 6(1): 49 - 55. 10.22391/fppc.752549
IEEE Aras G,Seçik Arkın F,DOGU E "Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?." Aile Hekimliği ve Palyatif Bakım, 6, ss.49 - 55, 2021. 10.22391/fppc.752549
ISNAD Aras, Gülfidan vd. "Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?". Aile Hekimliği ve Palyatif Bakım 6/1 (2021), 49-55. https://doi.org/10.22391/fppc.752549