Laboratory prognostic score for predicting 14-day mortality in terminally ill patients with gynecologic malignancy

Background There are few studies developing a scoring system for short-term survival of patients with gynecologic malignancy. Methods Seventy-three terminally ill patients with gynecologic malignancy who were admitted to our palliative care unit (PCU) from June 2009 to February 2018 were included. We accumulated routine blood data within 3 months before PCU discharge. Receiver-operating characteristic analysis was performed on each blood factor, and area under the curve (AUC) was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify significant independent prognostic factors of 14-day mortality. To develop a scoring system for 14-day mortality, laboratory prognostic score for gynecologic malignancy (G-LPS) was calculated using the sum of indices of the independent prognostic factors. Results Multivariable analysis showed that 6 of 24 indices, namely, C-reactive protein >= 13.3 mg/dL, total bilirubin >= 1.1 mg/dL, sodium < 131 mEq/L, blood urea nitrogen >= 28 mg/dL, white blood cell count >= 17.7 x 103/mu L, and eosinophil level < 0.2%, were significant independent factors of 14-day survival. G-LPS was obtained from the sum of the six indices. The AUC was 0.7977 at the optimal cut-off value of G-LPS 3. G-LPS 3 predicted death within 14 days with a sensitivity of 72% and a specificity of 79%. Conclusions Six of the 24 laboratory indices were identified as independent prognostic factors of 14-day mortality in terminally ill patients with gynecologic malignancy. G-LPS showed acceptable ability of predicting 14-day survival.

Automated summary

A scoring system for short-term survival of patients with gynecologic malignancy was developed based on six significant independent prognostic factors identified through multivariable analysis. The laboratory prognostic score for gynecologic malignancy (G-LPS) showed acceptable ability to predict 14-day survival with an AUC of 0.7977 at a cut-off value of G-LPS 3.