Predictive Factors of Death on Hospitalization in Patients With Advanced Cancer in Palliative Care.

Abstract

Prognostic assessment is essential to plan the care of patients with advanced cancer in palliative care. Thus, this study aims to assess the predictors of death in inpatients with advanced cancer in palliative care. This is a clinical, observational cohort study with patients aged >20 years, of both genders, evaluated within 48 hours of the first hospitalization. The independent variables were tumor location, nutritional risk [through the Patient-Generated Subjective Global Assessment (PG-SGA) short form], laboratory tests [C-reactive protein and albumin] and Karnofsky Performance Status (KPS). Logistic regression analyses were performed. Eighty-two patients were evaluated, whose mean age was 61.8 (± 13.2) years. Forty-nine (59.8%) patients died during hospitalization, among which the majority had KPS of 30-40% (p-value = 0.043), higher means of the total score of the PG-SGA (p-value = 0.050) and lower serum albumin concentrations (p-value = 0.011). According to the multivariate model, tumor location in the gastrointestinal (GI) tract (OR: 1.73; 95% CI: 1.57-1.94), 30-40% KPS (OR: 1.29; 95% CI: 1.07-1.63) and albumin concentrations <3.5 g/dL (OR: 4.65; 95% CI: 1.22-17.7) were independent factors associated with an increased chance of death from hospitalization. Presenting an advanced tumor with localization in the GI tract, KPS ≤40% and serum albumin concentration <3.5 g/dL at admission were predictors of death in inpatients under palliative care.