Inflamasyon ilişkili indeksler, palyatif bakım hastalarında kötü prognozu tanımlayabilir mi?

Amaç: Palyatif tıp, hastaların yaşam kalitesini artırmak için bütünsel bakım sağlar. Kişiselleştirilmiş bir tedavi planı için prognozu tahmin etmek çok önemlidir. Bu nedenle, biyobelirteç bazlı indekslere (mGPS, PI ve PNI) ek olarak rutin biyokimya testleri, tam kan sayımı (CBC) ve nötrofil/lenfosit oranlarının sağkalım tahmin özelliklerini araştırmayı amaçladık. Yöntem: 139 palyatif bakım hastasının yaşamlarının son 5 haftasındaki laboratuvar parametre değerleri, prognostik faktör skorları, tanıları ve sağkalım süreleri geriye dönük olarak değerlendirildi. Bulgular: Doksan bir (%65.5) hasta erkekti ve yaş ortalaması 65.9 (28-91 yıl) idi. Bu çalışmada incelenen her üç prognostik indeksin (mGPS, PI ve PNI) sonuçlarının hastalarımızın sağkalım süreleri ile istatistiksel olarak anlamlı bir ilişkisi olduğu bulundu. Ayrıca NLO, nötrofil yüzdesi, hemoglobin, serum albümin ve CRP değerlerinin her üç prognostik indeksin skorları ile istatistiksel olarak anlamlı bir ilişkisi olduğu görüldü. Ayrıca WBC, NLR, albümin ve CRP değerlerinin genel sağ kalım ile ilişkili olduğu saptandı. Sonuç: Bu indekslerin palyatif bakım hastalarında prognostik belirteçlere sahip olduğunu gösteren çalışmamızın sonuçları klinik sürecin yönetimine rehberlik edecektir. Hayatta kalma tahmini için prognostik araçları kullanan hastalar için kişiselleştirilmiş tedavi planları geliştirmede palyatif bakım klinisyenlerinin önemini vurgulamak istiyoruz.

Anahtar Kelimeler:

Palyatif bakım, modifiye Glasgow prognostik ölçeği, prognostic nutrisyonel index, prognostic index

Can inflammation-based indices describe the poor prognosis in palliative care patients?

Aim: Palliative medicine provides holistic care to increase the quality of life of patients. Predicting prognosis is critical for a personalized treatment plan. Therefore, we aimed to investigate the survival prediction properties of routine biochemistry tests, complete blood count (CBC) and neutrophil/lymphocyte ratios, in addition to biomarker-based indices (the mGPS, PI, and PNI). Materials and methods: The laboratory parameter values, prognostic factor scores, diagnoses and survival time of 139 palliative care patients in the last 5 weeks of their life were evaluated retrospectively. Results: Ninety-one (65.5%) patients were male and the average age was 65.9 years (28–91 years). Results of all three prognostic indices (the mGPS, PI, and PNI) investigated in this study were found to have a statistically significant relationship with the survival time of our patients. In addition, NLR, neutrophil percent, hemoglobin, serum albumin and CRP values were seen to have a statistically significant relationship with the scores of all three prognostic indices. Moreover, hand it is detected that WBC, NLR, albumin, and CRP values were associated with overall survival. Conclusion: The results of our study, which showed that these indices have prognostic markers in palliative care patients, will guide the management of the clinical process. We would like to emphasize the importance of palliative care clinicians in developing personalized treatment plans for patients using prognostic tools for survival prediction.

Keywords:

Palliative Care, Modified Glasgow Prognostic Score, Prognostic Nutritional Index, Prognostic Index,

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