Objectives The quality of end-of-life care based on advance care planning is very important, but it is still unclear which factors can predict the exact survival time of end-of-life patients. Although previous studies have shown that elevated serum creatinine (Scr) is associated with lower survival rates in patients with various cancers, little is known about the relationship between Scr and survival in end-of-life patients. We, therefore, investigated the association between Scr and survival in end-of-life patients at an acute palliative care unit.
Methods We analyzed the medical records of 281 patients admitted to the palliative care unit at Korea University Guro Hospital from July 2019 to June 2021. Patients were divided into low (<0.5mg/dL), normal (0.5-1.1mg/dL), high (>1.1mg/dL) Scr groups. The log-rank test of the Kaplan-Meier method was computed to evaluate the median survival time for each variable. Finally, multivariable Cox hazard analysis was performed by selecting statistically significant variables through stepwise selection in the univariable model.
Results The median survival time was short in the order of high Cr group, low Cr group, and normal Cr group.(p=0.002) Multivariable analysis identified that factors including male (HR=1.81; p=0.010), ECOG 4 (HR=3.43; p=0.032), TPN use (HR=1.84; p=0.023), low Scr (HR=1.22; p=0.046), high Scr (HR=2.74, p=0.001) were significantly related to poor survival time.
Conclusions We found that low Scr, as well as high Scr, is significantly associated with poor survival time in terminal cancer patients. A readily available and simple biomarker might be helpful to predict the prognosis in a palliative care setting.
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