Korean J Fam Pract. 2017; 7(3): 382-387  https://doi.org/10.21215/kjfp.2017.7.3.382
Evaluation of Palliative Prognostic Score and Use of Total Parenteral Nutrition for Predicting Survival in Terminally Ill Cancer Patients
Der-Lih Wang, Eun-Jung Kim*, Inseong Kim, Seunggyu Gwon, Donghyeok Park
Department of Family Medicine, Busan Veterans Hospital, Busan, Korea
Eun-Jung Kim
Tel: +82-51-601-6067, Fax: +82-51-601-6339
E-mail: wang6351@naver.com
Received: February 17, 2016; Revised: June 10, 2016; Accepted: July 7, 2016; Published online: June 20, 2017.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Accurate prediction of survival in terminally ill cancer patients is important for planning effective palliative care. The palliative prognostic (PaP) score was designed to predict life expectancy based on clinical symptoms and the clinician’s prediction of survival. The aim of this study was to evaluate the availability of PaP score for determining survival period, the effect of total parenteral nutrition (TPN) on the survival, and the relationship between PaP score and TPN in terminally ill cancer patients in Korea.
Methods: The study involved 61 patients with terminal cancer at one hospital in 2012. The PaP score was constructed with five variables (Karnofsky performance status, anorexia, dyspnea, total white blood cell count, and lymphocyte percentage) and clinical prediction of survival by physicians.
Results: Patients were divided into three groups according to PaP score: group A, ≤5.5; group B, 5.6–11, group C, 11.1–17.5. The 30-day survival probability was 100% for group A, 78.57% for group B, and 0% for group C. A moderate correlation was found between clinician’s predictions and actual survival (correlation coefficient=0.718). TPN had no effect on the survival of terminally ill cancer patients, and there was no significant relationship between TPN use and PaP score.
Conclusion: PaP score was proved to be a reliable tool for predicting survival in terminally ill cancer patients in Korea. It is necessary to establish evidence-based guidelines for use of TPN for these patients.
Keywords: Hospice Care; Survival Analyses; Total Parenteral Nutrition; Hospice
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