Sistema de Salut de Catalunya
Institut Català de la Salut
[Mirallas O, Vega KS, Gómez-Puerto D, López-Valbuena D, Salva de Torres C, Ucha JM, Rezqallah A, Bueno S, Molina G, Hernando-Calvo A, Aguilar-Company J, Roca M, Muñoz-Couselo E, Martínez-Martí A, Eremiev S, Macarulla T, Oaknin A, Saura C, Élez E, Felip E, Gómez Pardo P, Garralda E, Tabernero J, Serradell S, Carles J] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Martin-Cullell B] Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain. [Navarro V, Pedrola A, Berché R, Villacampa G, Viaplana C, Dienstmann R] Oncology Data Science (ODysSey) Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Recuero-Borau J] Medical Oncology Department, Hospital del Mar, Barcelona, Spain. [Andurell L, Palmas F, Burgos R] Unitat de Suport Nutricional, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Alonso A, Peñuelas Á] Infermeria, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2025-01-08T13:27:44Z
2025-01-08T13:27:44Z
2024-11
Mortality; Hospital oncology service; Prognostic factors
Mortalidad; Servicio de oncología hospitalaria; Factores pronósticos
Mortalitat; Servei d'oncologia hospitalària; Factors pronòstics
Background Prognostic factors for ambulatory oncology patients have been described, including Eastern Cooperative Oncology Group (ECOG), tumor stage and malnutrition. However, there is no firm evidence on which variables best predict mortality in hospitalized patients receiving active systemic treatment. Our main goal was to develop a predictive model for 90-day mortality upon admission. Methods Between 2020 and 2022, we prospectively collected data from three sites for cancer patients with hospitalizations. Those with metastatic disease receiving systemic therapy in the 6 months before unplanned admission were eligible to this study. The least absolute shrinkage and selection operator (LASSO) method was used to select the most relevant factors to predict 90-day mortality at admission. A multivariable logistic regression was fitted to create the PROgnostic Score for Hospitalized Cancer Patients (PROMISE) score. The score was developed in a single-center training cohort and externally validated. Findings Of 1658 hospitalized patients, 1009 met eligibility criteria. Baseline demographics, patient and disease characteristics were similar across cohorts. Lung cancer was the most common tumor type in both cohorts. Factors associated with higher 90-day mortality included worse ECOG, stable/progressive disease, low levels of albumin, increased absolute neutrophil count, and high lactate dehydrogenase. The c-index after bootstrap correction was 0.79 (95% CI, 0.75–0.82) and 0.74 (95% CI, 0.68–0.80) in the training and validation cohorts, respectively. A web tool (https://promise.vhio.net/) was developed to facilitate the clinical deployment of the model. Interpretation The PROMISE tool demonstrated high performance for identifying metastatic cancer patients who are alive 90 days after an unplanned hospitalization. This will facilitate healthcare providers with rational clinical decisions and care planning after discharge.
Merck S.L.U., Spain.
Article
Published version
English
Càncer - Prognosi; Càncer - Mortalitat; Hospitals - Ingressos i altes; Càncer - Tractament; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Patient Care::Hospitalization; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality; DISEASES::Neoplasms; Other subheadings::Other subheadings::/therapy; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::asistencia al paciente::hospitalización; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::mortalidad; ENFERMEDADES::neoplasias; Otros calificadores::Otros calificadores::/terapia
Elsevier
The Lancet Regional Health – Europe;46
https://doi.org/10.1016/j.lanepe.2024.101063
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
