基于姑息性表现量表的肿瘤晚期病人3个月生存预测模型的初步构建  

Preliminary construction of 3⁃month survival prediction model for patients with advanced tumors based on Palliative Performance Scale

作　　者：张伟[1] 费朝廷 朱冬梅 陈星[2] ZHANG Wei;FEI Chaoting;ZHU Dongmei;CHEN Xing(School of Medicine,Jiangsu University,Jiangsu 212013 China)

机构地区：[1]江苏大学医学院,江苏212013 [2]江苏大学附属医院

出　　处：《护理研究》2021年第14期2468-2471,共4页Chinese Nursing Research

基　　金：教育部人文社科青年基金项目,编号:18YJC880153。

摘　　要：目的:基于姑息性表现量表(PPS)初步构建肿瘤晚期病人3个月生存预测模型。方法:分析2018年1月—2019年9月江苏大学附属医院肿瘤科安宁疗护病房200例肿瘤晚期病人资料,绘制Kaplan-Meier生存曲线并运用Log-rank检验各变量组间的累计生存率差异,采用Cox比例风险回归模型进行多因素生存分析,筛选出肿瘤晚期病人生存时间的独立影响因素,并构建PI预测模型。结果:手术史(HR=0.671,P=0.009)、PPS评分(HR=2.240,P<0.001)、呼吸困难(HR=1.644,P=0.008)、吞咽困难(HR=1.602,P=0.028)、谵妄(HR=4.530,P<0.001)是肿瘤晚期病人生存的独立影响因素,由此建立的肿瘤晚期病人生存期PI预测模型为PI=-0.400X1+0.850X2+0.497X3+0.471X4+1.511X5,χ^(2)=99.081(P<0.001),其中,X_(1)为有手术史,X_(2)为PPS≤50%,X_(3)为呼吸困难,X_(4)为吞咽困难,X5为谵妄。根据PI值将病人分成高危、中危、低危3组,Log-rank检验显示组间生存率差异有统计学意义(P<0.001)。结论:PPS是肿瘤晚期病人生存期预测因子,有手术史是预后的保护因素,PPS≤50%、呼吸困难、吞咽困难、谵妄均为预后危险因素。Objective:To preliminarily construct 3⁃month survival prediction model for patients with advanced tumors based on Palliative Performance Scale.Methods:Data on 200 patients with advanced tumors in hospice care unit in oncology department in affiliated hospital of Jiangsu university from January 2018 to September 2019 was analysed,Kaplan⁃Meier survival curve was drawn and difference of cumulative survival rate among the variable groups was tested by Log⁃rank.Multivariate survival analysis was conducted by Cox proportional hazard regression model,so as to screen out independent influencing factors of survival of patients with advanced tumors and construct PI prediction model.Results:History of surgery(HR=0.671,P=0.009),PPS score(HR=2.240,P<0.001),dyspnea(HR=1.644,P=0.008),dysphagia(HR=1.602,P=0.028),delirium(HR=4.530,P<0.001)were independent influencing factors for survival time of patients with advanced tumors.The PI prediction model of survival of patients with advanced tumors based on above factors was PI=-0.400X1+0.850X2+0.497X3+0.471X4+1.511X5,χ^(2)=99.081(P<0.001).In which,X_(1) was history of surgery,X^(2) was PPS≤50%,X_(3) was dyspnea,X_(4) was dysphagia,and X5 was delirium.According to PI value,patients were divided into three groups with high,mediate and low risk.Log⁃rank test showed that difference of survival rate among the groups was statistically significant(P<0.001).Conclusions:PPS is a predictor factor of survival of patients with advanced tumors.History of surgery is protective factor of prognosis,and PPS≤50%,dyspnea,dysphagia,and delirium are all risk factors of prognosis.

关 键 词：姑息性表现量表 肿瘤 生存期 影响因素 预测 模型构建 护理 

分 类 号：R473.73[医药卫生—护理学]