Estado funcional y mortalidad en pacientes neoplásicos hospitalizados
Objectives: To assess the performance status and its relationship to morbid-mortality in hospitalized oncological patients in an internal medical service. Material and methods: Descriptive, protocolized and observational study. We analyzed clinical parameters, performance and emotional status, mo...
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| Publicado en: | Revista Médica Universitaria |
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| Autores principales: | , , , |
| Materias: | |
| Acceso en línea: | https://bdigital.uncu.edu.ar/fichas.php?idobjeto=3750 |
| Sumario: | Objectives: To assess the performance status and its relationship to morbid-mortality
in hospitalized oncological patients in an internal medical service.
Material and methods: Descriptive, protocolized and observational study. We analyzed
clinical parameters, performance and emotional status, morbidity and mortality during
a three month period. We carried out a comparative analysis between patients with
Karnofsky index <40 points (group A) and >40 points (group B). Data was analyzed
with Epi Info 6.04, and the criteria of statistical significance was p<0.05.
Results: We included 66 oncological patients, 21 (31.8%) in group A, with an average
Karnofsky index of 25 points (DS±12.09) and 45 (68.2%) in B, with a Karnofsky index
of 77 points (DS±16.65). 77.3% had solid neoplasm and 22.7% hematological. The
most frequent solid tumors were gastrointestinal (19.6%), breast (12.1%), lung
(9.1%) and carcinomas of unknown origin (7.6%) and acute leukemia (73.3%) in the
hematological group (73.3%). The majority of the patients in both groups were in an
advanced tumoral stage, 89.5% in A and 88.9% in B were in stage IV (pNS). The
average age was 59.57 years in A (DS±13.71) and 52.48 years in B (DS±15.65)
(pNS). The male sex was significantly more common in A (66.7% versus 44.4%
respectively) (p<0.05). The average length of stay was 17.57 days in A (DS±20.84)
and 13.53 in B (DS±16.29) (pNS). The evaluation of Diary Life Basic Activities [0.81
(DS±1.25) versus 4.57 points (DS±1.15)] and Instrumental Activities [0.57 (DS±0.74)
versus 4 points (DS±1.37)] were, as expected, superior in B (p<0.05). No differences
were found with respect to the co-morbidities between both groups (85.7% versus
82.2%) (pNS). Infections (52.4% versus 26.7%), poor social conditions (38.1%
versus 4.4%), neoplastic complications (81% versus 51.1%) and pain (81% versus
51.1%) were significantly more frequent due to hospitalization in group A (p<0.05).
Group A patients needed more frequent palliative care (90.5% versus 46.7%) and
received chemotherapy (90.5% versus 46.7%) (p<0.05), without differences in
radiotherapy (23.8% versus 13.3%) and surgery (33.3 versus 33.3%) (pNS). The
incidence of clinical depression and weight lost were similar in both groups (69.9%
versus 53.3%) (86.4% versus 84.2%) (pNS) respectively. Delirium, (85.7% versus
11.1%), prostration (61.9% versus 6.7%) and pressure ulcers (23.8% versus 4.4%)
were found in higher frequency in A (p<0.005). In-hospital mortality was greater in A
(52.4% versus 8.9%) (p<0.05).
Conclusion: The performance status evaluated by Karnofsky Index <40 in oncological
hospitalized patients resulted in an indicator of very bad prognosis.
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