Survival following palliative percutaneous nephrostomy tube insertion in patients with malignant ureteric obstruction: Validating a prognostic model

Gunawan, B; Foster, K; Hardy, J; Good, P

Survival following palliative percutaneous nephrostomy tube insertion in patients with malignant ureteric obstruction: Validating a prognostic model

Gunawan, B Foster, K Hardy, J Good, P

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Publisher:: Taylor and Francis Group
Publication Type:: Journal Article
Citation:: Progress in Palliative Care, 2022, 30, (1), pp. 21-28
Issue Date:: 2022-01-01

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Field	Value	Language
dc.contributor.author	Gunawan, B
dc.contributor.author	Foster, K
dc.contributor.author	Hardy, J
dc.contributor.author	Good, P https://orcid.org/0000-0002-8198-0375
dc.date.accessioned	2022-11-30T03:39:46Z
dc.date.available	2022-11-30T03:39:46Z
dc.date.issued	2022-01-01
dc.identifier.citation	Progress in Palliative Care, 2022, 30, (1), pp. 21-28
dc.identifier.issn	0969-9260
dc.identifier.issn	1743-291X
dc.identifier.uri	http://hdl.handle.net/10453/163899
dc.description.abstract	Background and Aims: Malignant ureteric obstruction (MUO) is a life-threatening complication of advanced cancer associated with short survival. Percutaneous nephrostomy (PCN) is a commonly employed technique to decompress MUO. Prognostic models have been developed to identify patients with poor outcomes. This study aimed to validate and update the recent model by Alawneh et al. [Alawneh A, Tuqan W, Innabi A, et al. Clinical Factors Associated With a Short Survival Time After Percutaneous Nephrostomy for Ureteric Obstruction in Cancer Patients: An Updated Model. J Pain Symptom Manag 2016;51(2):255–261]. Methods: A retrospective analysis was performed on patients who received PCN for MUO over a 10-year period. Clinical and demographic details were recorded. Patients were stratified into prognostic groups and survival was described using the Kaplan-Meier method. Association between prognostic group, individual variables and mortality was investigated. Results: 29 patients had received PCN for MUO. When stratified by Alawneh prognostic group, survival was 0.9 months (0 risk factors), 8.4 months (1 factor), 3.4 months (2 factors) and 4.1 months (3 factors). No statistical association was identified between prognostic group and mortality risk (Hazard Ratio [HR] 0.92; p = 0.72). The only variable associated with increased mortality was pre-nephrostomy haemoglobin <100 g/L (HR 2.6; p = 0.037). Conclusion: Survival with MUO remains short, despite advances in supportive care and PCN. This study was unable to either validate or update the prognostic model, due to limited numbers. Further research with prospective studies is recommended.
dc.language	en
dc.publisher	Taylor and Francis Group
dc.relation.ispartof	Progress in Palliative Care
dc.relation.isbasedon	10.1080/09699260.2021.1905145
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Gerontology
dc.title	Survival following palliative percutaneous nephrostomy tube insertion in patients with malignant ureteric obstruction: Validating a prognostic model
dc.type	Journal Article
utslib.citation.volume	30
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-11-30T03:39:45Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	30
utslib.citation.issue	1

Abstract:

Background and Aims: Malignant ureteric obstruction (MUO) is a life-threatening complication of advanced cancer associated with short survival. Percutaneous nephrostomy (PCN) is a commonly employed technique to decompress MUO. Prognostic models have been developed to identify patients with poor outcomes. This study aimed to validate and update the recent model by Alawneh et al. [Alawneh A, Tuqan W, Innabi A, et al. Clinical Factors Associated With a Short Survival Time After Percutaneous Nephrostomy for Ureteric Obstruction in Cancer Patients: An Updated Model. J Pain Symptom Manag 2016;51(2):255–261]. Methods: A retrospective analysis was performed on patients who received PCN for MUO over a 10-year period. Clinical and demographic details were recorded. Patients were stratified into prognostic groups and survival was described using the Kaplan-Meier method. Association between prognostic group, individual variables and mortality was investigated. Results: 29 patients had received PCN for MUO. When stratified by Alawneh prognostic group, survival was 0.9 months (0 risk factors), 8.4 months (1 factor), 3.4 months (2 factors) and 4.1 months (3 factors). No statistical association was identified between prognostic group and mortality risk (Hazard Ratio [HR] 0.92; p = 0.72). The only variable associated with increased mortality was pre-nephrostomy haemoglobin <100 g/L (HR 2.6; p = 0.037). Conclusion: Survival with MUO remains short, despite advances in supportive care and PCN. This study was unable to either validate or update the prognostic model, due to limited numbers. Further research with prospective studies is recommended.

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http://hdl.handle.net/10453/163899