Consciousness levels one week after admission to a palliative care unit improve survival prediction in advanced cancer patients
Journal
Journal of Palliative Medicine
Journal Volume
18
Journal Issue
2
Pages
170-175
Date Issued
2015
Author(s)
Abstract
Background: Consciousness is an important factor of survival prediction in advanced cancer patients. However, effects on survival of changes over time in consciousness in advanced cancer patients have not been fully explored. Objective: This study evaluated changes in consciousness after admission to a palliative care unit and their correlation with prognosis in terminal cancer patients. Methods: This is a prospective observational study. From a palliative care unit in Taiwan, 531 cancer patients (51.8% male) were recruited. Consciousness status was assessed at admission and one week afterwards and recorded as normal or impaired. Results: The mean age was 65.28±13.59 years, and the average survival time was 23.41±37.69 days. Patients with normal consciousness at admission (n=317) had better survival than those with impaired consciousness at admission (n=214): (17.0 days versus 6.0 days, p<0.001). In the analysis on survival within one week after admission, those with normal consciousness at admission had a higher percentage of survival than the impaired (78.9% versus 44.3%, p<0.001). Patients were further classified into four groups according to consciousness levels: (1) normal at admission and one week afterwards, (2) impaired at admission but normal one week afterwards, (3) normal at admission but impaired one week afterwards, and (4) impaired both at admission and one week afterwards. The former two groups had significantly better survival than the latter two groups: (median survival counted from day 7 after admission), 25.5, 27.0, 7.0, and 7.0 days, respectively. Conclusion: Consciousness levels one week after admission should be integrated into survival prediction in advanced cancer patients. ? Copyright 2015, Mary Ann Liebert, Inc. 2015.
SDGs
Other Subjects
adult; advanced cancer; aged; Article; cancer patient; cancer prognosis; cancer survival; consciousness; consciousness level; female; hospital admission; human; major clinical study; male; observational study; palliative therapy; survival prediction; survival time; Taiwan; classification; comparative study; middle aged; mortality; Neoplasms; palliative therapy; pathophysiology; physiology; prognosis; prospective study; statistics and numerical data; survival; time; Aged; Consciousness; Female; Humans; Male; Middle Aged; Mortality; Neoplasms; Palliative Care; Prognosis; Prospective Studies; Survival Analysis; Taiwan; Time Factors
Publisher
Mary Ann Liebert Inc.
Type
journal article