Korean J Geriatr Gerontol.  2016 Dec;17(2):59-67. 10.15656/kjcg.2016.17.2.59.

Validation of the Objective Prognostic Score for Terminal Cancer Patients in a Tertiary Hospital

Affiliations
  • 1Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea

Abstract

Background
OPS (Objective Prognostic Score) have been developed to predict the 3-week survival of terminally ill cancer patients from six training hospitals in Korea based on an integrated model using symptoms, performance status, and routine blood tests for inpatients in 2007. The purpose of this study is to validate OPS for terminally ill cancer patients in a tertiary hospital of Korea.
Methods
163 terminally ill cancer patients hospitalized at hospice palliative care unit of a university hospital in Korea from January 2012 to December 2013 were retrospectively analyzed. The OPS was calculated from the sum of partial scores obtained from following seven significant predictors: anorexia, dyspnea, the Eastern Cooperative Oncology Group (ECOG) performance status scale, white blood cell (WBC) count, total bilirubin, creatinine and lactate dehydrogenase (LDH). The accuracy of the OPS was evaluated.
Results
The median survival was 15 days (95% confidence interval 12∼18 days). The predictors that validated significant by the multivariate analysis were low performance status (HR=1.62; P=0.0295), leukocytosis (HR=1.46; P=0.0265), elevated serum bilirubin (HR=1.57; P=0.0164), elevated serum creatinine (HR=1.71; P=0.0258), and elevated serum LDH (HR=1.49; P=0.0320). The cutoff point for the prediction of survival time shorter than 3 weeks was set at 3.0 (sensitivity 82.1%, specificity 52.6%).
Conclusion
OPS has been validated in this population and was useful to predict the 3-week survival of terminally ill cancer patients in a tertiary hospital of Korea. It may help in making decisions about hospice care for patients and their families.

Keyword

Objective prognostic score; Terminal cancer; Survival prediction; Validation
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