Prognostic Factors for Patient with Terminal Cancer

 

Patient selection: terminally-ill cancer patient

 

Parameters:

(1) dyspnea

(2) C-reactive protein (CRP)

(3) total serum bilirubin (hyperbilirubinemia)

Parameter	Finding	Points
dyspnea	no	0
	yes	1
C-reactive protein	< 2.2 mg/dL	0
	>= 2.2 mg/dL (2200 µg/dL)	1
total serum bilirubin	<= 1.0 mg/dL	0
	> 1.0 mg/dL	1

 

where:

• In the US the upper limit of normal of total serum bilirubin for an adult is 1.1-1.2 mg/dL. The method is not given. In the implementation a value greater than the upper limit of normal will be given 1 point.

• The method for CRP and its reference range is not given.

• An elevated serum ALT (> 26 IU/L) had a p-value of 0.04 for short survival.

 

total number of risk factors for poor survival =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The higher the number the greater the risk of short survival.

• The hazard ratios ranged from 2.4 for dyspnea to 3.6 for CRP and hyperbilirubinemia.

• For an elevated CRP the 50% survival time was less than 2 weeks and 0% survival 8 weeks.