頁籤選單縮合
題名 | 癌末病患短期存活的預測因子=Predicting Factors of Short-term Survival in Patients with Terminal Cancers |
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作者 | 高以信; 劉鎮嘉; 鄭宇翔; 江瑞坤; 王美華; 陳世琦; 賴育民; | 書刊名 | 臺灣醫學 |
卷期 | 11:2 2007.03[民96.03] |
頁次 | 頁153-161 |
分類號 | 419.77 |
關鍵詞 | 安寧緩和; 癌末; 預後; Terminal; Hospice; Prognostic factor; |
語文 | 中文(Chinese) |
中文摘要 | 癌末病患的存活時間一直是病患家屬、病患以及安寧團隊所關心的議題。目前已有許多以病患的臨床症狀及徵候作為預後因子的研究,本研究主要藉由觀察病患的一般血液、生化檢測值及存活日期,期望找出存活期小於7日的預後影響因子,以提高對病患的存活時間的預估,提供更圓滿的照顧。本研究自2004年11月到2005年11月,共收集374位在安寧病房的癌末病患,完成收案的有311位(84%),我們以t檢定及卡方檢定比較描述性資料,以羅吉斯迴歸(Logistic regression)方法分析造成病患7日內往生可能因子的相對風險。結果為病患的平均住院天數為12±8天,存活時間的中位數為14天,存活時間小於7日佔27.8%,影響存活一星期的預後因子有四項,分別為:麩基氨酸-草醋酸轉氨基酶(SGOT)(勝算比1.773,p=0.0338)、白蛋白(Albumin)(勝算比1.905,p=0.0465)、血尿素氮(BUN)(勝算比4.188,p<0.0001)、以及血中白血球總量(WBC)(勝算比1.915,p=0.0201)。我們檢測的項目中發現有四項因子具有統計學上的意義。其中白蛋白過低代表惡體質;SGOT則代表肝癌(原發或轉移),深具影響及本土性;BUN過高導致末期氨血症(terminal azotemia)表示與臨終脫水狀態以及消化道出血等情形有關;WBC異常可能與病患處於感染與癌症轉移到全身等狀態有關。 |
英文摘要 | This issue that the survival time left behind for the terminal cancer patients is the major concern of the patients, families, and the hospice-care team. Up to date, many medical researches have paid their attention to prognostic scale of terminal cancer patients in hospice, but most of them base on patient's symptoms and signs. Our study focused on the observation of the routine lab data while they admitted, and found out the prognostic factors within 7 days. After improved survival prediction in terminal cancer patients, we can deliver more satisfactory care. A total of 375 consecutive patients admitted to the hospice ward at our hospital between November 2004 and November 2005. There were 311(84%) patients enrolled in our study and were followed until their death. The criteria to admit patients were followed by the law of hospice and palliative care in our country. We apply t test, chi-square test to compare the descriptive data, and logistic regression to test odds ratio of prognostic factors in patients within 7 days. In our study, the mean length of stay is 12±8 days, and the median survival time during admission is 14 days. There were 27.8% of patients who died within 7 days. We extracted four survival prognostic factors: SGOT(OR: 1.773, =0.0338), albumin (OR: 1.905, p=0.0465), BUN(OR: 4.188, p=<0.0001), and WBC(OR: 1.915, p value: 0.0201). Four survival prognostic factors with statistical significance are found in our study. The state of hypoalbuminemia means cachexia of patients; abnormal SGOT represents abnormal liver function and may be resulted from involvement of other vital organs; the elevation of BUN induced terminal azotemia reveals that dehydration and GI tract bleeding is correlated; the abnormality of WBC may imply patients are in states of infection and/or carcinomatosis. We hope to promote the quality of the hospice care through our study. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。