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Prognostic laboratory score to predict 14-day mortality in terminally ill patients with respiratory malignancy

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Abstract

Background

Some studies have developed a scoring system to determine the short-term survival of patients with respiratory malignancy.

Methods

A total of 649 terminally ill patients with respiratory malignancy admitted to our palliative care unit were included in this study. They were randomly divided into the investigation (n = 390) and validation (n = 259) groups. Nineteen blood parameters were analyzed in the laboratory. Receiver-operating characteristic analysis was performed for each blood factor and the area under the curve was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify the significant independent prognostic factors for 14-day mortality. To develop a scoring system, the laboratory prognostic score for respiratory malignancy (R-LPS) was calculated using the sum of the indices of the independent prognostic factors.

Results

Multivariable analysis showed that 8 out of 19 indices, namely, C-reactive protein ≥ 6.8 mg/dL, aspartate aminotransferase ≥ 43 U/L, blood urea nitrogen ≥ 22 mg/dL, white blood cell count ≥ 10.9 × 103/μL, eosinophil percentage ≤ 0.4%, neutrophil-to-lymphocyte ratio ≥ 12.0, red cell distribution width ≥ 16.8, and platelet count ≤ 168 × 103/μL were significant independent factors for 14-day survival in patients with respiratory malignancy. The R-LPS 3 showed acceptable accuracy for 14-day mortality in both the investigation and validation groups and predicted death within 14 days with 75–82% sensitivity and 59–62% specificity.

Conclusions

The R-LPS developed from eight laboratory indices showed acceptable prognostic ability for terminally ill patients with respiratory malignancy.

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Funding

This work is supported by the Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Research Grant (NFRCH21-001). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Mari Tanaka

  2. Department of Palliative Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Natsuko Kawai & Norihiro Yuasa

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  1. Mari Tanaka
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Correspondence to Norihiro Yuasa.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (approval reference number: 2016-130) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Institutional Review Board of our hospital, which waived the requirement for informed consent owing to the retrospective nature of the study.

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Tanaka, M., Kawai, N. & Yuasa, N. Prognostic laboratory score to predict 14-day mortality in terminally ill patients with respiratory malignancy. Int J Clin Oncol 27, 655–664 (2022). https://doi.org/10.1007/s10147-021-02105-5

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