Korean Journal of Family Medicine

"Survival"

Original Articles

Validation of the Simplified Palliative Prognostic Index to Predict Survival for Advanced Cancer Patients in Home Hospice Setting: Hyeon-Jeong Yang, Seok-Joon Yoon, Jong-Sung Kim, Sung-Soo Kim, Jin-Gyu Jung, Won Yoon Suh, Sami Lee, Hyun Gu Kim, Yong Woo Lee; Korean J Fam Med 2021;42(4):274-280. Published online July 20, 2021; DOI: https://doi.org/10.4082/kjfm.20.0160

Abstract
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Background
The simplified Palliative Prognostic Index (sPPI) substitutes a single item from the Communication Capacity Scale (CCS) for the delirium item of the original PPI. This study aimed to examine the validity of the sPPI for patients with advanced cancer in a home-based hospice care setting.
Methods
This study included 75 patients with advanced cancer who received home-based hospice care. We used medical records maintained by professional hospice nurses who had visited the patients in their homes. Based on their sPPI score, patients were divided into three groups—A (<4), B (≥4 and <6), and C (≥6)—to compare survival. Further, we investigated the sPPI’s accuracy using the area under the receiver operating characteristic curve (AUC) and sensitivity and specificity for 3- and 6-week survival. We used three sPPIs including different substitutions for the delirium item (two methods using the CCS and one using the Korean Nursing Delirium Screening Scale).
Results
The median survival was 60–61 days for group A, 27–30 days for group B, and 12–16 days for group C. The difference in survival was significant (P<0.05). The AUC was 0.814–0.867 for 3-week survival and 0.736–0.779 for 6-week survival. For 3- and 6-week survival, prognostic prediction showed sensitivities of 76.2%–90.9% and 76.3%–86.8%, and specificities of 64.2%–88.7% and 51.4%–70.3%, respectively.
Conclusion
The sPPI, which is measured by professional hospice nurses, has acceptable validity to predict survival for patients with advanced cancer in a home hospice setting in South Korea.

Citations

Citations to this article as recorded by

Comparison of Simplified Palliative Prognostic Index and Palliative Performance Scale in Patients with Advanced Cancer in a Home Palliative Care Setting
Yusuke Hiratsuka, Sang-Yeon Suh, Seok Joon Yoon
Journal of Palliative Care.2024; 39(3): 194. CrossRef
Survival prediction in advanced cancer patients – a narrative review
Shing Fung Lee, Charles B. Simone
Current Opinion in Supportive & Palliative Care.2023; 17(2): 105. CrossRef

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Survival Analysis of Patients with Alzheimer’s Disease: A Study Based on Data from the Korean National Health Insurance Services’ Senior Cohort Database: Tae Ho Huh, Jong Lull Yoon, Jung Jin Cho, Mee Young Kim, Young Soo Ju; Korean J Fam Med 2020;41(4):214-221. Published online April 23, 2020; DOI: https://doi.org/10.4082/kjfm.18.0114

Abstract
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Background
Korea’s rapidly aging population has experienced a sharp rise in the prevalence of dementia. Patients with Alzheimer’s disease (AD), which is estimated to be about three-quarters of all patients with dementia, tend to have higher mortality rates compared with patients without Alzheimer’s disease. In this study, a survival analysis of patients with AD was conducted in order to provide knowledge to those who provide medical care to these patients.
Methods
Data on individuals over 65 years old in 2004 were extracted from the Korean National Health Insurance Services’ Senior Cohort database (2002–2013). The subjects were 209,254 patients, including 2,695 who were first diagnosed with AD (the AD group) and 206,559 that had not been diagnosed with the disease (non-AD group). To investigate the independent effect of AD on survival, the Cox proportional-hazards model, hazard ratios (confidence interval of 95%), and the Kaplan-Meier method were used.
Results
Mean survival time in the AD group was 5.3±3.3 years, which was about 2.5 years shorter than that in the non-AD group (7.8±2.4 years). The mortality rate in the AD group (66.3%) was higher than that in the non-AD group (26.3%). The adjusted hazard ratio in the AD group was 2.5 and, therefore, it was found that the AD group had a 2.5-fold higher risk of death than the non-AD group.
Conclusion
Overall, AD has a large, independent impact on survival. Survival time was shorter, and the mortality rate and risk were generally higher in the AD group, compared with the non-AD group.

Citations

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Therapeutic Potential of Sea Cucumber-Derived Bioactives in the Prevention and Management of Brain-Related Disorders: A Comprehensive Review
Purnima Rani Debi, Hrishika Barua, Mirja Kaizer Ahmmed, Shuva Bhowmik
Marine Drugs.2025; 23(8): 310. CrossRef
Clinical profile and survival analysis of Alzheimer’s disease patients in a Brazilian cohort
Elisa de Melo Queiroz, Christian Marques Couto, Cláudio Antônio da Cruz Mecone, Waneska Souza Lima Macedo, Paulo Caramelli
Neurological Sciences.2024; 45(1): 129. CrossRef
Survival After the Diagnosis of Mild‐to‐Moderate Alzheimer's Disease Dementia: A 15‐Year National Cohort Study in Taiwan
Yu Sun, Chih‐Ching Liu, Chung‐Yi Li, Ming‐Jang Chiu
International Journal of Geriatric Psychiatry.2024;[Epub] CrossRef
Collaborative Survival Analysis on Predicting Alzheimer’s Disease Progression
Wanwan Xu, Selena Wang, Li Shen, Yize Zhao
Statistics in Biosciences.2024;[Epub] CrossRef
Effect of choline alfoscerate in older adult patients with dementia: an observational study from the claims data of national health insurance
Khanh Linh Duong, Heeyoon Jung, Hyun-kyoung Lee, Young Jin Moon, Sang Ki Lee, Bo Ram Yang, Hwi-yeol Yun, Jung-woo Chae
BMC Geriatrics.2024;[Epub] CrossRef
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Rei Ono, Takashi Sakurai, Taiki Sugimoto, Kazuaki Uchida, Takeshi Nakagawa, Taiji Noguchi, Ayane Komatsu, Hidenori Arai, Tami Saito
Journal of Alzheimer's Disease.2023; 92(2): 487. CrossRef
Infections among individuals with multiple sclerosis, Alzheimer’s disease and Parkinson’s disease
Yihan Hu, Kejia Hu, Huan Song, Yudi Pawitan, Fredrik Piehl, Fang Fang
Brain Communications.2023;[Epub] CrossRef
Independent effects of amyloid and vascular markers on long‐term functional outcomes: An 8‐year longitudinal study of subcortical vascular cognitive impairment
Sung Hoon Kang, Sook‐young Woo, Seonwoo Kim, Jun Pyo Kim, Hyemin Jang, Seong‐Beom Koh, Duk L. Na, Hee Jin Kim, Sang Won Seo
European Journal of Neurology.2022; 29(2): 413. CrossRef
Deep learning algorithm reveals probabilities of stage‐specific time to conversion in individuals with neurodegenerative disease LATE
Xinxing Wu, Chong Peng, Peter T. Nelson, Qiang Cheng
Alzheimer's & Dementia: Translational Research & Clinical Interventions.2022;[Epub] CrossRef
Time‐to‐event prediction using survival analysis methods for Alzheimer's disease progression
Rahul Sharma, Harsh Anand, Youakim Badr, Robin G. Qiu
Alzheimer's & Dementia: Translational Research & Clinical Interventions.2021;[Epub] CrossRef

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Validation of the Prognosis in Palliative Care Study Predictor Models in Terminal Cancer Patients: Eun-Shin Kim, Jung-Kwon Lee, Mi-Hyun Kim, Hye-Mi Noh, Yeong-Hyeon Jin; Korean J Fam Med 2014;35(6):283-294. Published online November 21, 2014; DOI: https://doi.org/10.4082/kjfm.2014.35.6.283

Abstract
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Background

Prognosis in Palliative Care Study (PiPS) predictor models were developed in 2011 to estimate the survival of terminal cancer patients in the United Kingdom. The aim of this study was to validate the PiPS model for terminal cancer patients in Korea, and evaluate its value in clinical practice.

Methods

This study included 202 advanced cancer patients who were admitted to the cancer hospital's palliative care ward from November 2011 to February 2013. On admission, physicians recorded the PiPS-A, PiPS-B, and doctor's survival estimates in inpatients.

Results

The median survival across PiPS-A categories was 9, 28, and 33 days, and the median survival across PiPS-B was 9.5, 27, and 43 days. The median actual survival was 25 days; overall accuracy between the PiPS-A, PiPS-B, doctor's estimates of survival, and actual survival was 52.0%, 49.5%, and 46.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'days' showed a sensitivity of 48.4% and 64.1%, and specificity of 87.7%, and 77.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'weeks' showed a sensitivity of 59.2%, and 44.7%, and specificity of 61.6%, and 64.7%, respectively. The PiPS-A and PiPS-B 'months' group showed a sensitivity of 37.1% and 37.1%, and specificity of 74.9% and 78.4%, respectively. The 'weeks' and 'months' groups showed significantly prolonged survival rates than 'days' group did in both PiPS-A and PiPS-B, by the Kaplan-Meier method.

Conclusion

The PiPS predictor models effectively predicted the survival ≥14 days in terminal cancer patients, and were superior to doctor's estimates.

Citations

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Validation of the prognostic model for palliative radiotherapy in older patients with cancer
Hyojung Park
World Journal of Clinical Oncology.2025;[Epub] CrossRef
Prognosis palliative care study, palliative prognostic index, palliative prognostic score and objective prognostic score in advanced cancer: a prospective comparison
Seung Hun Lee, Jeong Gyu Lee, Young Jin Choi, Young Mi Seol, Hyojeong Kim, Yun Jin Kim, Yu Hyeon Yi, Young Jin Tak, Gyu Lee Kim, Young Jin Ra, Sang Yeoup Lee, Young Hye Cho, Eun Ju Park, Youngin Lee, Jungin Choi, Sae Rom Lee, Ryuk Jun Kwon, Soo Min Son
BMJ Supportive & Palliative Care.2024; 14(e1): e1016. CrossRef
Malignancy-related ascites in palliative care units: prognostic factor analysis
Toru Kadono, Hiroto Ishiki, Naosuke Yokomichi, Tetsuya Ito, Isseki Maeda, Yutaka Hatano, Tomofumi Miura, Jun Hamano, Takashi Yamaguchi, Ayaka Ishikawa, Yuka Suzuki, Sayaka Arakawa, Koji Amano, Eriko Satomi, Masanori Mori
BMJ Supportive & Palliative Care.2023; 13(e3): e1292. CrossRef
Das LUEBECKER-Modell in der Palliativmedizin
Andreas S. Lübbe, Frank Gieseler
Im Fokus Onkologie.2022; 25(3): 21. CrossRef
Imminent death: clinician certainty and accuracy of prognostic predictions
Nicola White, Fiona Reid, Victoria Vickerstaff, Priscilla Harries, Christopher Tomlinson, Patrick Stone
BMJ Supportive & Palliative Care.2022; 12(e6): e785. CrossRef
Onkologische Systemtherapie bei Palliativpatienten: Beendigung oder Fortführung?
Jorge Riera Knorrenschild
TumorDiagnostik & Therapie.2021; 42(02): 105. CrossRef
The Prognosis in Palliative care Study II (PiPS2): A prospective observational validation study of a prognostic tool with an embedded qualitative evaluation
P. C. Stone, A. Kalpakidou, C. Todd, J. Griffiths, V. Keeley, K. Spencer, P. Buckle, D. Finlay, V. Vickerstaff, R. Z. Omar, Tim Luckett
PLOS ONE.2021; 16(4): e0249297. CrossRef
Prognostic models of survival in patients with advanced incurable cancer: the PiPS2 observational study
Patrick Stone, Anastasia Kalpakidou, Chris Todd, Jane Griffiths, Vaughan Keeley, Karen Spencer, Peter Buckle, Dori-Anne Finlay, Victoria Vickerstaff, Rumana Z Omar
Health Technology Assessment.2021; 25(28): 1. CrossRef
Deep-Learning Approach to Predict Survival Outcomes Using Wearable Actigraphy Device Among End-Stage Cancer Patients
Tien Yun Yang, Pin-Yu Kuo, Yaoru Huang, Hsiao-Wei Lin, Shwetambara Malwade, Long-Sheng Lu, Lung-Wen Tsai, Shabbir Syed-Abdul, Chia-Wei Sun, Jeng-Fong Chiou
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Validation of the Palliative Prognostic Index, Performance Status–Based Palliative Prognostic Index and Chinese Prognostic Scale in a home palliative care setting for patients with advanced cancer in China
Jun Zhou, Sitao Xu, Ziye Cao, Jing Tang, Xiang Fang, Ling Qin, Fangping Zhou, Yuzhen He, Xueren Zhong, Mingcai Hu, Yan Wang, Fengjuan Lu, Yongzheng Bao, Xiangheng Dai, Qiang Wu
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A non-lab nomogram of survival prediction in home hospice care patients with gastrointestinal cancer
Muqing Wang, Xubin Jing, Weihua Cao, Yicheng Zeng, Chaofen Wu, Weilong Zeng, Wenxia Chen, Xi Hu, Yanna Zhou, Xianbin Cai
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Experiences and Opinions Related to End-of-Life Discussion: From Oncologists' and Resident Physicians' Perspectives
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The effects of performance status, clinical symptoms and laboratoy data on length of survival of advanced cancer patients.: Do Haeng Lee, Soo Hyun Kim, Youn Seon Choi, Byung Chul Chun, Myung Ho Hong, Kyung Hwan Cho, Jeong A Kim; J Korean Acad Fam Med 2001;22(12):1794-1805. Published online December 1, 2001

Abstract
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Background
: Patients diagnosed as an advanced cancer and families need accurate information about the length of survival in order to plan for and to make the best use of the time that remains. The health care of that patient can then be redirected toward palliation and mobilizing resources to ensure a comfortable life. The purposes of this study were to evaluate the prognostic value of performance status plus some physical symptoms and some biological indices and therefore to assist in planning appropriate palliative care.

Methods : This study was performed on 151 patients, who had been diagnosed as advanced cancer in Korean University Guro Hospital from July 1999 to July 2000.: We requested Karnofsky performance status scale, mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea and dry mouth. We assessed the biological indices by leukocyte count, plasma albumin, proteinuria.

Results : We could confirm 82 patients' death(54.3%) of 151 patients. Univariate analysis showed that Karnofsky status scales mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea, dry mouth, leukocyte count, albumin and proteinuria demonstrated a statistically significant predictive prognosis. Multivariate analysis using Cox's proportional hazard model showed that age, performance status, albumin, proteinuria were independent predictors of survival and severity of pain had the borderline value.

Conclusion : Age, performance status, albumin and proteinuria were the independent prognostic factors for patients with advanced cancer.