Carga de sintomas e capacidade funcional como fatores prognósticos em pacientes em cuidados paliativos oncológicos

• Autor(a) principal: Silva, Liziane Pereira
• Data de Publicação: 2022
• Outros Autores: [e-mail]
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/18509
• topic: Palliative care; Functionality; Symptoms; Prognostic factors; Survival; Cuidados paliativos; Funcionalidade; Sintomas; Fatores prognósticos; Sobrevida; CIENCIAS DA SAUDE::SAUDE COLETIVA

Patients in palliative care (PC) oncology have a high burden of symptoms and a tendency to lose functional capacity. In this dissertation we sought to evaluate the role of symptom burden and functional capacity as prognostic factors in patients in PC oncology. A retrospective observational cohort study was conducted in a public palliative care unit. The Kaplan-Meier method and Cox proportional hazards model stratified by sex were used to calculate survival to analyze the predictive power of functional capacity and symptom burden on survival, as assessed by the Karnofsky Performance Status (KPS) and the Edmonton Symptom Assessment System (ESAS) respectively. 404 patients were included in the study, KPS 30 - 50% was found to have a greater association with the risk of dying in both women (adjusted HR 1.84 95% CI 1.33-2.54) and men (adjusted HR 3.07 95% CI 2.14 -4.41). The and the moderate/intense ESAS total score also showed a relationship with shorter survival for both genders (women: adjusted HR 1.56 95% CI 1.15-2.11; men: adjusted HR 2.27 95% CI 1.60 - 3.20). Regarding individual symptoms there were differences between women and men regarding the association with the worst prognosis for women and men, respectively: moderate/intense pain (adjusted HR 1.38 95% CI 1.02-1.87; adjusted HR 2.15 95% CI 1.53- 3. 02 ), moderate/intense fatigue (adjusted HR 1.97 CI 1.43-2.72; adjusted HR 2.24 CI 95 % 1.74-3.86 ) and dyspnea (adjusted HR 1.68 CI 95% 1.17- 2.43; adjusted HR 2.51 CI 95% 1.64 -3.86 ) In this study the role of KPS and symptom burden as independent prognostic factors can be ratified. Based on this information, it was possible to provide health professionals with indications regarding the clinical condition and prognosis of the patient, contributing to the elaboration of priorities and objectives in the planning of the care plan in an outpatient consultation.