Predictors of response to palliative care intervention for chronic nausea in advanced cancer outpatients.
Predictors of response to palliative care intervention for chronic nausea in advanced cancer outpatients.
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DOI：
10.1007/s00520-013-1805-8
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发表时间：
2013-09
影响因子：
3.1
通讯作者：
Bruera, Eduardo
中科院分区：
文献类型：
--
作者：
Rhondali, Wadih;Yennurajalingam, Sriram;Chisholm, Gary;Ferrer, Jeanette;Kim, Sun Hyun;Kang, Jung Hun;Filbet, Marilene;Bruera, Eduardo
恶心是晚期癌症患者中常见且令人痛苦的症状。这项回顾性研究的目的是确定晚期癌症门诊患者慢性恶心姑息治疗咨询反应的预测因素。入选的合格患者是在门诊支持性治疗中心连续接受初始咨询，并在初始咨询后30天内接受一次随访的患者。我们回顾了1273例连续患者的病历，发现444例（35%）符合合格标准。所有患者均采用埃德蒙顿症状评估量表（ESAS）进行评估。恶心缓解定义为初次访视和首次随访之间至少改善30%。我们使用逻辑回归模型来评估恶心改善的可能预测因素。112/444例患者（25%）发生中度/重度慢性恶心（ESAS项目评分≥4/10）。较高的基线恶心强度与便秘（r=0.158; p=0.046）和ESAS评估的所有症状（p<0.001）显著相关。基线时中度/重度恶心的112例患者中有68例（61%）在随访访视时显示出显著改善（p<0.001）。恶心反应的主要预测因素是疲劳改善（p=0.005）和食欲增加（p=0.003）。基线恶心与所有ESAS症状相关，疲劳和食欲不振的改善预测随访时恶心频率较低。需要进行更多的研究，以更好地了解恶心严重程度与其他症状之间的关联，并根据症状的混合和严重程度预测哪些干预措施将产生最佳结果。
Nausea is a frequent and distressing symptom in advanced cancer patients. The objective of this retrospective study was to determine predictors of response to palliative care consultation for chronic nausea in advanced cancer outpatients. Eligible patients included were outpatient supportive care center seen consecutively for an initial consultation and who had one follow-up visit within 30 days of the initial consultation. We reviewed the medical records of 1273 consecutive patients, and 444 (35%) were found to meet the eligibility criteria. All patients were assessed using the Edmonton Symptom Assessment Scale (ESAS). Nausea response was defined as an improvement of at least 30% between the initial visit and the first follow-up. We used logistic regression models to assess the possible predictors of improvement in nausea. 112/444 patients (25%) experienced moderate/severe chronic nausea (ESAS item score ≥4/10). Higher baseline nausea intensity was significantly related to constipation (r=0.158; p=0.046) and all the symptoms assessed by the ESAS (p<0.001). Sixty-eight of the 112 (61%) patients with moderate/severe nausea at baseline showed a significant improvement at the follow-up visit (p<0.001). The main predictors for nausea response were improvement of fatigue (p=0.005) and increased appetite (p=0.003). Baseline nausea was associated with all the ESAS symptom and improvement of fatigue and lack of appetite predicted a lower frequency of nausea at follow-up. More research is necessary to better understand the association between nausea severity and other symptoms and to predict which interventions will yield the best outcomes depending on the mix and severity of symptoms.
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影响因子：
4.7
作者：
Delgado-Guay, Marvin;Yennurajalingam, Sriram;Bruera, Eduardo
通讯作者：
Bruera, Eduardo
影响因子：
4.7
作者：
Gomez-Batiste, Xavier;Porta-Sales, Josep;Rodriguez, Jose
通讯作者：
Rodriguez, Jose
DOI：
10.1016/0277-5379(83)90418-2
发表时间：
1983-01-01
期刊：
EUROPEAN JOURNAL OF CANCER & CLINICAL ONCOLOGY
影响因子：
--
作者：
COATES, A;ABRAHAM, S;TATTERSALL, MHN
通讯作者：
TATTERSALL, MHN
影响因子：
1.7
作者：
Bruera, E;Neumann, C;Quan, H
通讯作者：
Quan, H
影响因子：
7.4
作者：
Farrar, JT;Portenoy, RK;Strom, BL
通讯作者：
Strom, BL