A Retrospective Study Of Prognostic Factors Of Patients With Tumor In Hospice Care

Objective Tumor has become the leading cause of death in mankind, its mechanism is not completely clear. Tumor patients without nonspecific symptoms are difficult to be detected in early stage, which were detected at advanced stage and its prognosis are poor. Its incidence rate and death rate is increasing year by year. Based on the retrospective analysis on clinical data of tumor patients in hospice care, this study focuses on discussing the prognosis influence of various factors on tumor patients’ survival and providing some evidences for clinical decision.Methods 1132 tumor patients who received service of hospice in the First Affiliated Hospital of Guangxi Medical University from April 2010 to December 2012 were taken part in follow-up investigation and retrospective analysis.1132 cases were recorded according to their personal information, including gender, age, educational background, income, primary diagnosis, time of confirmed diagnosis, awareness of their illness, surgical operations, chemotherapy, radiotherapy, time of pain appearing, past pain treatments history, Numerical rating scale (NRS), Karnofsky performance status (KPS) score and Quality of life (QOL). Retrospective analysis and follow-up investigation were performed by telephone calls and door-to-door interviews. The follow-up terminated when the patients died from tumor. Survival time was the time of diagnosis to the point of death or termination of the follow-up. The data, including non-tumor deaths, missing cases or surviving cases as investigation terminated, were treated as censored data in analysis. SPSS 16.0 software was used to practice statistical analysis, survival time was analyzed and survival curve was drawn by Kaplan-Meier method while the significant difference was evaluated by the Log-rank test. Multivariate analysis of variables was performed using the Cox proportional hazard regression.Results The follow-up survey terminated on June,30th 2013, including 1044 (92.2%) complete cases and 88 (7.8%) censored cases. The average survival time of all the patients who died from tumor was 20.2 months and the median survival time was 9.5 months. Six-month cumulative survival rate was 66.5%, one-year was 43.1% and five-year 6.6%. According to univariate analysis, relevant risk factors of survival prognosis were including gender, awareness of their illness, primary diagnosis, surgical operations, chemotherapy, and radiotherapy, time of pain appearing, past pain treatments history and KPS score and QOL. Multivariate analysis showed that gender, awareness of their illness, primary diagnosis, surgical operations, chemotherapy, radiotherapy, time of pain appearing, past pain treatments history and KPS score are the independent prognostic factors of tumor patients’survival time.Conclusion The survival time of the tumor patients in hospice care were dramatically decreasing as time went by. Gender, awareness of their illness, primary diagnosis, surgical operations, chemotherapy, radiotherapy, time of pain appearing, past pain treatments history and KPS score are the independent prognostic factors of survival time of tumor patients. Therefore, early detection, accurately understanding diseases, early pain control and effective intervention means are significant ways to prolong the survival time of tumor patients.