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Objective:To evaluate the prognostic value of Karnofsky performance scores (KPS) in elderly patients with sepsis, so as provide a basis for clinical evaluation of the condition, prognosis and corresponding treatment measures.Methods:A retrospective cohort study was conducted to collect the general information, clinical data, and follow-up data of limb motor function status and self-care ability of elderly patients with sepsis who were hospitalized in the Intensive Care Unit of our hospital from January 2018 to June 2021. Patients were divided into the survival group and death group according to whether they survived the hospitalization. Statistical analysis was performed using t-test, chi-square test, and Mann-Whitney test. The KPS score before admission, disease severity scores (APACHEⅡ and SOFA), serum procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and arterial blood lactate level on admission were compared between the two groups. Then, the factors with significance in univariate analysis were analyzed by Logistic regression method, the independent risk factors for predicting in-hospital mortality were determined, and the receiver operating characteristic (ROC) curve was drawn to evaluate the prognostic value of KPS score in elderly patients with sepsis.Results:A total of 135 patients were collected. There were 85 males and 50 females, 60 died and 75 survived during hospitalization, with a mortality rate of 44.4%. The preadmission KPS score of elderly patients with sepsis in the death group was significantly lower than that in the survival group [30 (30, 40) vs. 70 (50, 90), P<0.001]. Multivariate logistic regression analysis showed that KPS score ( OR=0.938, 95% CI: 0.914-0.963, P<0.001), SOFA score ( OR=1.255, 95% CI: 1.066-1.451, P=0.002) and arterial blood lactate ( OR=1.219, 95% CI: 1.059-1.404, P=0.006) were independent risk factors for predicting the prognosis during hospitalization. ROC curve analysis of mortality showed that compared with SOFA score and blood lactate, the area under the curve of KPS score was the largest, with AUC of 0.830 (95% CI: 0.756-0.890, P<0.001). In addition, the combination of KPS, SOFA and blood lactate had a greater predictive value for the prognosis of elderly patients with sepsis than that of the single index, with an AUC of 0.883 (95% CI: 0.826-0.940, P<0.001). Conclusions:The lower the KPS score, the worse the prognosis of elderly patients with sepsis. The KPS score can be used as a clinical indicator to predict the prognosis of elderly patients with sepsis.
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Objective To investigate the advantage of neuronavigation assisted microsurgical resection of gliomas in eloquent areas of brain. Methods The clinical data of 99 patients with gliomas in eloquent areas of brain and underwent microsurgery in the First Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2017 were analyzed retrospectively. All patients were divided into two groups: neuronavigator-guided microsurgery group (neuronavigation group,46 cases) and non-neuronavigator-guided microsurgery group (non-neuronavigation group,53 cases). The neuronavigation group received neuronavigation assisted microsurgery, while the non-neuronavigation group received general microsurgery. MRI examination, Karnofsky performance scale (KPS) score and symptomatic improvement rate were used to analyze the extent of resection and postoperative function. Results The total resection rate of neuronavigation group was 91.3% (42/46). Comparing with 73.6% (39/53) total resection rate in non-neuronavigation group,the difference of total resection rate was statistically significant (Z=-2.343,P＜0.05). The postoperative symptoms improved both in neuronavigation group and non-neuronavigation group,and the KPS score at discharge were higher than that before operation (P＜0.05). No aggravation of symptoms and signs or new complications occurred in all patients except one case of postoperative muscle strength decline in non-neuronavigation group after the surgery. According to tumor size,the total resection rate of neuronavigation group and non-neuronavigation group among patients whose maximum size of tumor≥3cm were 89.5%(34/38) and 72.5%(37/51) respectively. The difference of total resection rate was statistically significant between these two groups (Z=-2.040,P＜0.05). Conclusion Neuronavigation assisted microsurgical resection of gliomas in brain eloquent areas can improve the rate of total resection and postoperative quality of life without increase in postoperative complications.
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Objective To assess the clinical efficacy and safety of percutaneous vertebroplasty(PVP)in the treatment of breast cancer patients with vertebral metastases. Methods Retrospective analysis of 83 breast cancer patients with spinal metastases underwent PVP was conducted. The scores of visual analogue,Karnofsky performance status and mobility were evaluated 24 h before and 24 h,1 month,3 and 6 months after PVP. Re-sults All patients were successfully completed the operation with no serious complications. After PVP,all the scores were improved,with a statistically significant difference between 24 h before PVP and 24 h,1 month,3 and 6 months after PVP(P < 0.05). Conclusions PVP can significantly relieve pain and improve the quality of life for breast cancer patients with vertebral metastases.
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Objective:To observe the clinical effect of Xuefuzhuyu decoction in the treatment of cancerous fever .Methods:Ac-cording to the admission order , 62 cases of patients with cancerous fever were divided into observation group (32 cases) and control group(30 cases).The observation group was treated with Xuefuzhuyu decoction , while the control group was treated with naproxen . The treatment course was 7 days.The changes of body temperature and KPS score were compared between the groups before and after the treatment,and the clinical efficacy of the two groups were evaluated .Results:After the 5-7-day treatment, the average body tem-perature in the observation group was significantly lower than that in the control group (P<0.05).After the treatment, the total effec-tive rate of the observation group was 75％, which was much higher than that (50％) of the control group (P<0.05).The rate of KPS score keeping stable or ≥10 in the observation group was much higher than that in the control group (P<0.05).Conclusion:Xuefuzhuyu decoction is effective and safe in the treatment of cancerous fever with better efficacy than naproxen , which can improve pa-tients' quality of life with important clinical significance .
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AIM: To evaluate the efficacy and safety on the radio-heating-chemotherapy in treatment of patients with malignant pleural effusion (MPE). METHODS: 60 patients of MPE were randomly devided into two groups, radio-chemotherapy group (treatment group) and chemotherapy group (control group). The drugs, according to the types of tumor cells, were select to take intravenous injection and pleural cavity administration. The patient’s pleural cavity was drained continuously by pleurocentesis. These treatments were made once two week lasting for 4-6 weeks with NS 30 ml+cisplatin 60 mg by perfusion of pleural cavity. After the perfusin of pleural cavity, radio-heating was performed 60-90 min, twice one week for 8-10 times in the treatment group. RESULTS: The response rate was 90% (CR+PR) in the treatment group, and 67% (CR+PR) in the control group. The rates were higher than those in the control group (P
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OBJECTIVE: Prognostic factors of metastatic brain tumors have been widely reported and their operative indications also have been extended gradually even to the poor grade patients. Authors intended to analyze the causative factors for the clinical outcome of metastatic brain tumors, especially with relevant to the poor prognosis by one year follow-up evaluation. PATIENTS AND METHODS: The authors retrospectively studied the clinical characteristics of 46 cases(35 patients) with metastatic brain tumors among 466 cases(437 patients) which were operated on due to the brain tumor, during the period between January 1994 to June 1999. Statistical analysis was performed by using SPSS 8.0(r). A p-value of less than 0.05 was considered clinically significant. RESULT: Among the variable clinical factors in patients with metastatic brain tumors, Karnofsky Performance Scale (KPS) score of less than 70(16 patients), uncontrolled primary tumor(8 patients), and surgical resection without further adjuvant therapy(9 patients) showed statistically significant poor prognosis; p value of 0.002, 0.032, and 0.001, respectively. Other tested variables, such as old age(greater than 65 years; 10 patients), gender(male; 20 patients), type of primary cancer(primary undefined; 6 patients, lung cancer; 15 patients), location(infratentorial; 9 patients, sellar; 5 patients), number of lesion(multiple; 12 patients), and number of operation(multiple craniotomy; 7 patients) were not related to the poor prognosis. CONCLUSIONS: The most common primary site of distant metastasis was lung. The poorer prognosis was highly correlated with various factors including low KPS score(<70), no postoperative adjuvant therapy, and uncontrolled primary tumors.