A Retrospective Observational Study to Explore Trajectories of Hematologic Data and Palliative Performance Scale Scores in the Last 12 Weeks among Patients with Terminal-stage Cancer

ABSTRACT

Objective: To explore the trajectories of hematologic data and palliative performance scale (PPS) scores among patients with terminal-stage cancer. Method: This was a retrospective observational study. We recruited all adult patients with solid cancer who received care from palliative care specialists and died in Komaki City Hospital between January and December 2016. Among these patients, we extracted hematologic data from the last 12 weeks and when 2 weeks passed since the last anti-cancer treatment, and PPS scores on the day of the hematologic tests. We calculated the means of weekly hematologic data and PPS scores, and explored their trajectories. Results: We recruited 204 patients (mean age, 70.9 years; women, 44.1%) and acquired 1157 hematological datasets. Albumin and C-reactive protein levels gradually decreased from 12 weeks and increased from 5 weeks, respectively, before death. White blood cell and lymphocyte counts respectively increased and decreased from 5 weeks. Creatinine and bilirubin levels rapidly increased from 3 weeks. Potassium levels increased from 1 week. PPS scores decreased from 4 weeks before death. Discussion: Deteriorations in nutrition or inflammatory status and white blood cell counts could antedate deterioration in PPS scores, and deterioration of visceral data and PPS scores could indicate prognosis on a weekly basis.