Independent Validation of the Modified Prognosis Palliative Care Study Predictor Models in Three Palliative Care Settings

被引：33

作者：

Baba, Mika ^{[1
]}

Maeda, Isseki ^{[2
]}

Morita, Tatsuya ^{[3
]}

Hisanaga, Takayuki ^{[4
]}

Ishihara, Tatsuhiko ^{[5
]}

Iwashita, Tomoyuki ^{[6
]}

Kaneishi, Keisuke ^{[7
]}

Kawagoe, Shohei ^{[8
]}

Kuriyama, Toshiyuki ^{[9
]}

Maeda, Takashi ^{[10
]}

Mori, Ichiro ^{[11
]}

Nakajima, Nobuhisa ^{[12
]}

Nishi, Tomohiro ^{[13
]}

Sakurai, Hiroki ^{[14
]}

Shimoyama, Satofumi ^{[15
]}

Shinjo, Takuya ^{[16
]}

Shirayama, Hiroto ^{[17
]}

Yamada, Takeshi ^{[18
]}

Ono, Shigeki ^{[19
]}

Ozawa, Taketoshi ^{[20
]}

Yamamoto, Ryo ^{[21
]}

Tsuneto, Satoru ^{[22
]}

机构：

[1] Saito Yukoukai Hosp, Dept Palliat Care, Ibaraki, Osaka 5670085, Japan

[2] Osaka Univ, Grad Sch Med, Dept Palliat Med, Suita, Osaka, Japan

[3] Seirei Mikatahara Gen Hosp, Palliat & Support Care Div, Hamamatsu, Shizuoka, Japan

[4] Tsukuba Med Ctr Fdn, Tsukuba, Ibaraki, Japan

[5] Okayama Saiseikai Gen Hosp, Palliat Care Dept, Okayama, Okayama, Japan

[6] Matsue City Hosp, Matsue, Shimane, Japan

[7] JCHO Tokyo Shinjuku Med Ctr, Dept Palliat Care Unit, Shinjuku Ku, Tokyo, Japan

[8] Aozora Clin, Matsudo, Chiba, Japan

[9] Wakayama Med Univ Hosp, Ctr Oncol, Dept Palliat Med, Wakayama, Japan

[10] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Dept Palliat Care, Bunkyo Ku, Tokyo, Japan

[11] Gratia Hosp Hosp, Mino, Osaka, Japan

[12] Tohoku Univ, Grad Sch Med, Dept Palliat Med, Sendai, Miyagi 980, Japan

[13] Kawasaki Municipal Ida Hosp, Kawasaki Comprehens Care Ctr, Nakahara Ku, Kawasaki, Kanagawa, Japan

[14] St Lukes Int Hosp, Dept Palliat Care, Chuo Ku, Tokyo, Japan

[15] Aichi Canc Ctr Hosp, Dept Palliat Care, Chikusa Ku, Nagoya, Aichi 464, Japan

[16] Shinjo Clin, Kobe, Hyogo, Japan

[17] Iryouhoujinn Takumikai Osaka Kita Homecare Clin, Osaka, Osaka, Japan

[18] Nippon Med Sch, Dept Gastrointestinal & Hepatobiliary Pancreat Su, Bunkyo Ku, Tokyo 113, Japan

[19] Shizuoka Canc Ctr Hosp, Div Palliat Med, Shizuoka, Japan

[20] Megumi Zaitaku Clin, Yokohama, Kanagawa, Japan

[21] Saku Cent Hosp, Adv Care Ctr, Dept Palliat Med, Saku, Nagano, Japan

[22] Kyoto Univ, Grad Sch Med, Dept Multidisciplinary Canc Treatment, Sakyo Ku, Kyoto, Japan

来源：

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT | 2015年 / 49卷 / 05期

关键词：

Prognosis palliative care study predictor models; modified; prognostic score; palliative setting; validation study; ILL CANCER-PATIENTS; CONSULTATION SERVICE; SURVIVAL PREDICTION; SCORE; INDEX; PROGNOSTICATION; PAP;

D O I：

10.1016/j.jpainsymman.2014.10.010

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Context. Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams. Objectives. The primary aim of this study is to examine the accuracy and to validate the modified PiPS (using physician-proxy ratings of mental status instead of patient interviews) in three palliative care settings, namely palliative care units, hospital-based palliative care teams, and home-based palliative care services. Methods. This multicenter prospective cohort study was conducted in 58 palliative care services including 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services in Japan from September 2012 through April 2014. Results. A total of 2426 subjects were recruited. For reasons including lack of followup and missing variables (primarily blood examination data), we obtained analyzable data from 2212 and 1257 patients for the modified PiPS-A and PiPS-B, respectively. In all palliative care settings, both the modified PiPS-A and PiPS-B identified three risk groups with different survival rates (P < 0.001). The absolute agreement ranged from 56% to 60% in the PiPS-A model and 60% to 62% in the PiPS-B model. Conclusion. The modified PiPS was successfully validated and can be useful in palliative care units, hospital-based palliative care teams, and home-based palliative care services. (C) 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

引用

页码：853 / 860

页数：8

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