Low Serum Creatinine as Well as High Serum Creatinine Is Associated with Prognosis of Patients with Cancer in End-of-Life.

IF 1.4 Q4 PRIMARY HEALTH CARE
Yoo Jeong Lee, Soon-Young Hwang, Su Hyun Kim, Youn Seon Choi
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Abstract

Background: The prognosis of end-of-life patients is challenging, and clinicians have attempted to predict survival more accurately. High serum creatinine (sCr) levels are associated with lower survival rates in patients with various cancers; however, low sCr levels are commonly expected in patients with terminal cancer because of muscle wasting and malnutrition. Therefore, we investigated the prevalence of low and high sCr levels and their association with survival duration in patients with terminal cancer in a palliative care unit.

Methods: We analyzed the medical records of 280 patients admitted to a palliative care unit. Patients were divided into low (<0.5 mg/dL), normal (0.5-1.2 mg/dL), and high (>1.2 mg/dL) sCr groups. Kaplan-Meier survival curves using sCr levels were plotted and compared using the log-rank test. Using stepwise selection, a multivariable Cox proportional hazards model was used to identify the significant prognostic factors.

Results: The median survival durations in the high-, low-, and normal-sCr groups were 9.57 days, 22.26 days, and 27.51 days, respectively. Multivariable Cox proportional hazard model identified that males (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.16-2.85), poor performance status (HR, 3.43; 95% CI, 1.12-10.54), total parenteral nutrition use (HR, 1.84; 95% CI, 1.09-3.1), high sCr (HR, 2.74; 95% CI, 1.52-4.94), and low sCr (HR, 1.22; 95% CI, 1.07-1.43) were significantly associated with a shorter survival time.

Conclusion: Low and high serum creatinine levels were significantly associated with poor survival in patients with cancer at the end-of-life stage. Therefore, readily available and simple biomarkers may help plan advanced care in palliative care settings.

低血清肌酸和高血清肌酸与癌症患者的预后相关。
背景:临终患者的预后具有挑战性,临床医生试图更准确地预测生存率。在患有各种癌症的患者中,高血清肌酐(sCr)水平与较低的生存率相关;然而,由于肌肉萎缩和营养不良,癌症晚期患者的sCr水平通常较低。因此,我们调查了姑息治疗病房中癌症晚期患者的低和高sCr水平的患病率及其与生存时间的关系。方法:我们分析了280例姑息治疗患者的病历。患者被分为低(1.2 mg/dL)sCr组。使用sCr水平绘制Kaplan-Meier生存曲线,并使用对数秩检验进行比较。使用逐步选择,使用多变量Cox比例风险模型来确定重要的预后因素。结果:高、低和正常sCr组的中位生存期分别为9.57天、22.26天和27.51天。多变量Cox比例风险模型表明,男性(风险比[HR],1.81;95%置信区间[CI],1.16-2.85)、不良工作状态(HR,3.43;95%置信指数,1.12-10.54)、全胃肠外营养使用(HR,1.84;95%置信度,1.09-3.1)、高sCr(HR,2.74;95%可信区间,1.52-4.94)和低sCr(HR1.22;95%置信系数,1.07-1.43)与较短的生存时间显著相关。结论:癌症终末期患者血清肌酸酐水平高低与生存率低显著相关。因此,现成且简单的生物标志物可能有助于在姑息治疗环境中规划高级护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Korean Journal of Family Medicine
Korean Journal of Family Medicine PRIMARY HEALTH CARE-
CiteScore
4.00
自引率
4.30%
发文量
51
审稿时长
53 weeks
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