Validation of the Cochin Risk Index Score (CRIS) for life expectancy prediction in terminally ill cancer patients

Support Care Cancer. 2012 Apr;20(4):857-64. doi: 10.1007/s00520-011-1163-3. Epub 2011 Apr 16.

Abstract

Background: Oncologists often overestimate survival of advanced cancer patients. This study aimed to validate a score for survival prediction in terminally ill cancer patients.

Methods: Between 2004 and 2008, a prospective study was performed in 500 consecutive advanced cancer patients referred to a palliative care unit. Evaluation at admission included physical examination and routine blood tests. On a randomly selected training set, independent factors assessable at inclusion predicting 2-week survival by a multiple logistic regression were assigned integer-rounded weights to develop a risk index score, which was tested on a validation set.

Results: On the training set (334 patients), predictive factors were: urea >12 mmol/L (weight = 5, odds ratio (OR) = 3.72, 95% confidence interval (95%CI) = [1.59; 8.71], p = 0.002), Karnofsky Performance Status ≤30% (weight = 4, OR = 3.28, 95%CI = [1.80; 6.01], p < 0.001), leucocytes >15 g/L (weight = 3, OR = 2.49, 95%CI = [1.18; 5.25], p = 0.017), transthyretin ≤0.05 g/L (weight = 3, OR = 2.42, 95%CI = [1.16; 5.04], p = 0.019) and male gender (weight = 2, OR = 2.25, 95%CI = [1.28; 3.97], p = 0.005). On the validation set (166 patients), the Cochin Risk Index Score (CRIS) ≥ 7 identified high-risk patients, with a positive predictive value of 78%.

Conclusion: We validated the CRIS for survival prediction in terminally ill cancer patients.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Karnofsky Performance Status
  • Life Expectancy*
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasms / pathology*
  • Palliative Care / methods*
  • Predictive Value of Tests
  • Prospective Studies
  • Sex Factors
  • Survival Analysis
  • Terminally Ill*
  • Young Adult