姑息性功能状态评分在晚期癌症住院患者预后评估中的应用

Application of Palliative Performance Scale in the prognosis assessment of advanced cancer patients

目的探讨姑息性功能状态评分与晚期癌症患者30 d、90 d死亡风险的关系,识别姑息性功能状态评分在临终关怀实践中的参考价值。方法回顾194份晚期癌症患者的电子病历及随访记录,评估姑息性功能状态评分与患者生存期的相关性,并分析影响患者30 d、90 d死亡风险的主要因素。结果样本平均生存时间为(33.5±1.6)d;姑息性功能状态评分与患者生存时间呈中度正相关(r=0.643,P<0.01),以姑息性功能状态评分分层的30 d、90 d Kaplan-Meier生存曲线分析结果显示,姑息性功能状态评分30%、40%、50%之间有显著差异(Log-rank检验,P<0.05),评分10%、70%显示出相对独立性(Log-rank检验,P<0.05);Cox回归显示,姑息性功能状态评分、年龄及肿瘤手术史为晚期癌症患者30 d、90 d死亡风险的独立影响因素。结论姑息性功能状态评分与晚期癌症患者生存期相关,可为临终关怀实践提供一定参考。

Objective To explore the relationship between Palliative Performance Scale(PPS)score and the risk of death at 30 days and 90 days in advanced cancer patients,and to identify the reference value of PPS in hospice care practice.Methods The electronic medical records and follow-up records of 194 advanced cancer patients were retrospectively reviewed,the relationship between PPS score and patient survival time was assessed,and the main factors influencing patients′risk of death at 30 days and 90 days were analyzed.Results The mean survival time of the whole study population was(33.5±1.6)days.The PPS score was moderately and positively correlated with survival time(r=0.643,P<0.01).The results of Kaplan-Meier survival curve of 30 days and 90 days stratified by PPS score showed that,there was significant difference among PPS score of 30%,40%,50%(Log-rank test,P<0.05),and PPS score of 10%,70%revealed relatively independence(Log-rank test,P<0.05).Cox regression indicated that,PPS score,age and history of tumor surgery were the independent factors influencing the risk of death in advanced cancer patients at 30 days and 90 days.Conclusion PPS score is related to the survival time of patients with advanced cancer,and it can provide reference for hospice care practice.