Factors Associated with Karnofsky Performance Status and its Trajectory in the Last Month of Life in Patients with Terminal Cancer

• Autor(a) principal: Muniz, Andrezza Helena Regadas
• Data de Publicação: 2023
• Outros Autores: Rosa, Karla Santos da Costa, Resende, Juliana Miranda Dutra de, Sampaio, Simone Garruth dos Santos Machado, Oliveira, Livia Costa de
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista Brasileira de Cancerologia (Online)
• Texto Completo: https://rbc.inca.gov.br/index.php/revista/article/view/2754
• topic: avaliação de estado de Karnofsky; neoplasias; doente terminal; cuidados paliativos; prognóstico; Karnofsky performance status; neoplasms; terminally Ill; palliative care; prognosis; estado de ejecución de Karnofsky; neoplasias; enfermo terminal; cuidados paliativos; pronóstico

Introduction: Karnofsky Performance Status (KPS) can characterize the impact of the disease on cancer patients. Objective: To evaluate the factors associated with KPS and its trajectory in the last month of life in patients with terminal cancer. Method: Retrospective cohort study, with terminal cancer patients enrolled in a Palliative Care Unit, who died between July and August 2019. The dependent variable was the KPS assessed daily in the last month of life. A cross-sectional analysis of factors associated with initial KPS was performed using ordinal logistic regressions. To verify the trajectory of KPS in the last month of life, longitudinal graphic analyzes were performed. Results: 108 patients were evaluated, most of whom were >60 years old (68.5%) and female (62.0%). The most prevalent tumor sites were the gastrointestinal tract (GIT) (24.3%), breast (18.7%) and head and neck (HN) (16.8%). In the multiple model, the primary tumor sites remained associated with KPS. During the last month of life, the reduction in KPS was more pronounced in those with tumors in the GIT, HN and connective bone tissue, who had higher KPS values on the thirtieth day before death when compared to the others. On the other hand, those with central nervous system and lung cancer started the follow-up period with lower KPS values and had a less exacerbated reduction than the others. Conclusion: KPS values decrease in the last month of life, but with different intensity according to the tumor site in patients with terminal cancer.