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Med. paliat ; 19(4): 133-138, oct.-dic. 2012. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-108821

RESUMO

Objetivo: 1) Determinar la capacidad predictiva de la escala Palliative Performance Status v2(PPSv2) para el pronóstico de supervivencia de los pacientes con cáncer avanzado. 2) Determinarlas características y la supervivencia de una cohorte de pacientes oncológicos ingresados en una Unidad de Cuidados Paliativos Hospitalaria. Material y método: estudio longitudinal prospectivo de una cohorte de 157 pacientes con cáncer con una expectativa de vida menor de tres meses. Criterios de exclusión: 1) Pacientes en situación de agonía con muerte inminente y 2) PPSv2 al ingreso mayor o igual del 80%. Variables obtenidas: edad, sexo, tipo, localización y extensión del cáncer, PPSv2 durante la valoración inicial, tiempo de supervivencia a partir del ingreso. Ámbito del estudio: unidad de cuidados paliativos de hospital universitario. Resultados: el tamaño de la muestra fue de 157 enfermos ingresados de forma consecutiva en nuestra unidad. La media de edad fue de 69,27 ± 12,24 años con una mediana de 71 años y un predominio del sexo masculino (61,8%). La localización más frecuente del cáncer fue la respiratoria (20,4%). La media y la mediana de supervivencia global fueron respectivamente19,85 días (95% IC 16,7-23,0) y 13 días (95% IC 10,3-15,7). Debido a su poco número se agruparon los casos con PPSv2 ≥ 50%. El 73,9% de los casos tenían un PPSv2

Objective: 1) to estimate the predictive value of the Palliative Performance Status Scale (PPS)for the prognosis of survival of patients with advanced cancer. 2) to clarify the profile and survival rate of a group of oncology patients admitted into a hospital palliative care unit. Material and method: A prospective longitudinal study was performed on a cohort of157 patients with cancer and an expected survival rate of less than three months. Selection criteria: patients were excluded in situation of agony with imminent death or their PPSv2 at admission was equal to or higher than 80%. Variables used were: age, sex, type of tumour, location and extension of cancer, PPSv2 on admission and survival time. Study setting: palliativecare unit of a university hospital. Results: The study included 157 patients consecutively admitted to our unit. Mean age was69.27 ± 12.24 years, with a median of 71 years and a majority of males (61.8%). The most common cancer site was the respiratory system (20.4%). The mean and median of overall survival were 19.85 days (95% CI; 16.7-23.0) and 13 days (95% CI; 10.3-15.7). Due to their small number, all the cases with a PPSv2 ≥ 50% were analysed together. Of the whole study 73% of cases had aPPSv2 < 30%, 16.6% had a PPSv2 of 40%, and 9.5% had a PPSv2 ≥ 50%. Median survival of patients with a PPSv2 of 10% was 6 days compared with 15 days for a PPSv2 of 30%, and 32 days for scores greater than 50%.Conclusions: The PPS scale on admission proved to be a useful tool to evaluate the survival of patients on palliative care. The lowest scores having a clear association with the lowest survivals. Thus, the periodical determination of the PPSv2 can be a useful prognostic tool (AU)


Assuntos
Humanos , Análise de Sobrevida , Modelos de Riscos Proporcionais , Neoplasias/mortalidade , Progressão da Doença , Valor Preditivo dos Testes
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