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頁籤選單縮合
題名 | 老年癌末病人住院後二星期內死亡之預測因子=Prognostic Factors in Predicting Death within 2 weeks after Hospice Admission in Elderly Terminally ill Cancer Patients |
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作者 | 江瑞坤; 高以信; 陳世琦; 賴育民; 盧豐華; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷期 | 5:3 2010.08[民99.08] |
頁次 | 頁216-227 |
分類號 | 419.76 |
關鍵詞 | 老年; 癌末; 預測因子; Elderly; Terminally ill cancer; Prognostic factors; |
語文 | 中文(Chinese) |
中文摘要 | 目的︰分析老年癌末病人住院後至死亡小於或等於二星期的預測因子。 方法︰本研究為病歷回顧法,收集 2004年11月至2007年5月間,以癌末住院之老年病人作為研究對象,登錄該些病人第一次入住安寧病房之病歷內所記載病人住院後 24小時內的基本人口學資料、臨床特徵、症狀、徵候及病人的死亡日期等資料。 結果︰本研究共有433位老年癌末病人納入分析,其中住院後至死亡時間小於或等於二星期者有187位(43.2%),大於二星期者有 246位(56.8%)。病人的平均年齡為 74.7±6.3歲,存活中位日數為17日。在兩組間之比較,存活小於或等於二星期組罹患肝癌者較多、有較差的身體功能、較少的便秘與失眠、心搏次數較快、呼吸次數較快、較常有下肢水腫、意識不清、腹水及黃疸。多因子分析之結果,有顯著正相關的預測因子包括︰男性 (p < 001)、心搏次數 (p = 0.004)、身體功能差者 (p < 0.001)、黃疸 (p = 0.036)及腹水 (p = 040),負相關的預測因子為癌症原發部位為胃癌者 (β = -1.045,p = 0.025)。進一步計算老年病人住院後至死亡時間小於或等於二星期之機率,其準確性為74.1%。 結論︰藉由本研究發現的男性、癌症原發部位為胃癌者、身體功能狀態、心搏次數、腹水、及黃疸等預測因子,將可增進醫護人員對老年癌末病人存活期的預測能力,進而提升老年癌末病人的安寧照護品質。 |
英文摘要 | Objectives: The purpose of this study is to analyze the different factors in predicting mortality within 2 weeks of hospice admission in elderly cancer patients at terminal stage. Methods: This is a retrospective study on elderly patients, who were admitted to the hospital-based hospice ward during the period from November 2004 to May 2007. Data were collected from chart review, including demographic data, clinical characteristics, symptoms, and signs within 24 hours after admission, and the date of mortality. Results: Of the 433 patients who were enrolled in the study, 187 patients died within 2 weeks after hospice admission, and 246 patients survived for more than 2 weeks. When comparing between the two groups, we found several factors significant in the group of death within 14 days after admission. These include hepatoma, worse performance status, absence of constipation and insomnia, tachycardia and the presence of tachypnea, more frequent lower leg edema, conscious disturbance, jaundice and ascites. According to the results of logistic regression analysis, the positive significant factors are male (p < 0.001), heart rate (p = 0.004), worse performance status (p < 0.001), jaundice (p = 0.036), and ascites (p = 0.040); the negative significant factor is gastric cancer (β = -1.045, p = 0.025). Conclusion: Our studies showed that certain factors can affect the mortality of these elderly cancer patients. We will organize and develop protocol to help physicians predict the prognostic factors and provide more appropriate and compassionate care to these patients and their families. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。