Diagnostic Model Developed for Impending Death in Patients with Cancer

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A diagnostic model for impending death within 3 days was developed for patients with cancer, according to an article published online in the journal Cancer.

In this study, the investigators systematically documented 62 physical signs every 12 hours from patient admission to acute palliative care units (APCUs) to death or discharge for a total of 357 patients diagnosed with advanced cancer.

Results showed 322 out of the 357 patients (90%) had complete data for all signs. The 3-day mortality rate for these patients was 24% on admission to APCUs.

A model for impending death was developed with two variables acting as its foundation: Palliative Performance Scale (PPS) and drooping of nasolabial folds. Moreover, the model was based on 4 terminal leaves: PPS score less than or equal to 20% and drooping of nasolabial folds present, PPS score less than or equal to 20% and drooping of nasolabial folds absent, PPS score of 30% to 60%, and PPS score greater than or equal to 70%.

The authors determined the 3-day mortality rates for the four terminal leaves to be 94%, 42%, 16%, and 3%, respectively.

Furthermore, this model was determined to be applicable at time of admission to APCUs and during subsequent days: 81% diagnostic accuracy for the original tree, 80% for cross-validation, and 79% to 84% for subsequent days.

Hospitalizations Higher for Childhood Cancer Survivors
A diagnostic model for impending death within 3 days was developed for patients with cancer.
Sixty-two physical signs were systematically documented every 12 hours from admission to death or discharge for 357 patients with advanced cancer who were admitted to acute palliative care units (APCUs) at 2 tertiary care cancer centers. Recursive partitioning analysis was used to develop a prediction model for impending death within 3 days with admission data.
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