Prediction of Next-Day Survival in Imminently Dying Cancer Patients: A Multicenter Cohort Study

• DOI: 10.1089/jpm.2024.0334
• Publication Date: 2025-02-10T17:13:47Z
• Authors: Masanori Mori; Takuhiro Yamaguchi; Isseki Maeda; Yutaka Hatano; Shih-Wei Chiu; Takashi Yamaguchi; Kengo Imai; Naosuke Yokomichi; Hiroyuki Otani; Jun Hamano; Satoru Tsuneto; David Hui; Tatsuya Morita
• Keywords: Cancer Survival

Background: Accurate prediction of next-day survival in imminently dying patients is crucial for facilitating timely end-of-life decisions. Objectives: To develop diagnostic models predicting cancer with a Palliative Performance Scale (PPS) score ≤20. Design: A multicenter, prospective, observational study. Setting/subjects: We enrolled advanced at 23 palliative care units across Japan. Measurements: Clinical signs impending death were recorded daily after patients' PPS scores decreased to ≤20, continuing until or up 14 days. The developed included the one-day survival-decision tree (P1d-Survival-DT), based on recursive partitioning analysis, P1d-Survival-organ system score, which utilized scoring four clinical systems (nervous/cardiovascular/respiratory/musculoskeletal), and early model that focused absence two (altered consciousness liquid dysphagia). Results: Of 1896 study, 1396 (74%) reached average age was 73 ± 12 years, 49% being female. P1d-Survival-DT showed rates 91.6% response verbal stimuli no peripheral cyanosis, 37.1% those respiration mandibular movement. revealed 95.9% rate = 0, decreasing progressively 46.7% 4. predicted 95.2% normal dysphagia. Conclusions: This study successfully three distinct predict offering vital tools informed decision making settings.