Factors influencing the survival time of patients with advanced cancer at the end of life: a retrospective study.

Abstract

Background: Predicting the survival time of patients at the end of life can provide more accurate treatment and care programs for patients. The purpose of this study was to investigate the factors impacting 14-day survival at the end of life.

Method: This was a retrospective study. Patients with advanced cancer admitted to the Department of Palliative Medicine in a tertiary hospital in China in 2021 were included and classified into group A (survival time ≤ 14 days) or group B (survival time > 14 days). Patient demographic characteristics, palliative performance scale (PPS) scores, Barthel index scores, Fracture Risk Assessment Scale (FRAIL) scale scores, clinical features and laboratory test results were extracted from medical records. Univariable and multivariable logistic regression analyses were used to identify predictors of death within 14 days. Survival time was compared between frail and nonfrail patients.

Results: A total of 261 patients were included (122 in group A and 139 in group B), with a median survival time of 17 (13.04, 20.96) days. There were significant differences in age, FRAIL score, PPS, Barthel index, dyspnea, edema, C-reactive protein and white blood cell count between the two groups. According to the multivariable logistic regression analysis, the PPS could predict the risk of death within 14 days (OR = 6.818, 95% CI = 3.944-11.785, p < 0.001). The median survival time was 48 (33.71, 62.29) days in the nonfrail group (n = 34) and 15 (12.46, 17.54) days in the frail group (n = 227) (p < 0.001).

Conclusions: A lower PPS increases the risk of 14-day mortality in patients at the end of life. Frailty may shorten the survival time of patients at the end of life.