晚期癌痛居家宁养患者生存期及其相关因素分析

Survival and Related Factors of Patients with Advanced Cancer Pain in Home-based Hospice Care

[目的]通过对晚期癌痛居家患者的基本状况、癌痛强度、活动能力、生活质量、生存期的调查,分析其生活现状及其相关影响因素,构建晚期癌痛居家患者生存模型。[方法]选取310例上海市崇明地区晚期癌痛居家患者作为统计分析对象,分析患者疼痛强度数字评分、活动能力、生活质量及生存期与患者性别、年龄、文化水平、居住情况、家庭人均月收入、肿瘤种类之间的相关性,并利用自适应助推法(adaptive boosting)构建晚期癌痛居家患者生存期分类模型。[结果]晚期癌痛居家患者的生存期与患者疼痛数字评分呈负相关,与活动能力评分、生活质量评分呈正相关,患者基本状况包括性别、年龄、文化水平、居住情况、家庭人均月收入和肿瘤种类,都是影响晚期癌痛居家肿瘤患者生存期的直接或间接因素。基于以上研究结果构建了分类正确率约为70%的晚期癌痛居家患者生存期分类模型。[结论]晚期癌痛居家患者作为一个特殊的弱势群体,影响其生活质量及生存期的因素较为复杂,通过adaptive boosting算法构建的分类模型可以为居家医疗服务提供参考意见。

[Purpose]To analyze the survival and related factors of patients with advanced cancer pain in home-based hospice care.[Methods]Three hundred and ten advanced cancer patients in Chongming district were followed up.The data of numeric rating scales(NRS)score,activity ability,quality of life(QOL)and survival were collected,and the correlation between the above data and gender,age,educational level,living conditions,income and cancer types of patients were analyzed.The adaptive boosting method was employed to build the survival classification model of advanced cancer patients.[Results]The survival of advanced cancer patients was negatively correlated with NRS score,and positively correlated with Karnofsky’s performance scale(KPS)score and QOL score.Gender,age,educational level,living conditions,income,cancer types were all direct or indirect factors influencing the survival of advanced cancer patients.The classification model for survival of advanced cancer pain patients was established based on adaptive boosting method and its prediction accuracy was higher than 70%.[Conclusion]Advanced cancer pain patients are a special vulnerable group and the factors affecting their survival and QOL are relatively complex.The classification model based on adaptive boosting method can accurately predict the service cycle of patients and provide reference suggestions for home-based hospice service.