Oriol Mirallas, fourth-year resident oncologist at Vall d’Hebrón Hospital.
Achieve improved quality of life hospitalized patients It is one of the key axes within all the medical specialties. Currently there are very clear parameters that mark the prognosis in outpatients, whether the condition improves or not, if it is self-sufficient, etc. Despite this, the hospitalized metastatic cancer patient with treatment does not currently have any tool to take into account for the prediction of their hospital stay. This unknown encouraged Oriol Mirallas, fourth year resident oncologist at the Vall d’Hebron Hospitalto start a multicenter validation study for predict mortality in advanced-stage hospitalized cancer patients with active treatment.
to make a prediction about the mortality and the hospital stay of the patient was the goal that Mirallas set himself as a result of having been working on the floor for hospitalized cancer patients. The resident explains Medical Writing that “normally when the patient has to be admitted it is because he is in a acute processin a monitoring for a treatment or in a end of life process. From here we can achieve a tool to predict the forecast of admission to know the possibilities that the patient had”.
study the analytical and clinical parameters to understand how the evolution of the patient will progress has been the key to advancing the project. “We collected the information prospectively based on five pillars what are the anxiety Y depression, quality of life, nutrition, Medical history Y tumor characteristics. Among these blocks we select a total of 45 variables that we want to reduce to fifteen to create a tool that allows us to discriminate the patient with a prediction that is as accurate as possible”, explains Mirallas.
“We want to create a tool that allows us to discriminate the patient with a prediction that is as accurate as possible”
The first part of the work was presented at the congress held by the Spanish Society of Medical Oncology (SEOM), offering promising results in 772 patients and multiplying the capacity of 30 day prediction. “We managed to have a prediction of those patients who could die before 30 days and those who managed to survive more than six months. The variables allowed us to make a graph to know what prognosis each patient had and what length of hospital stay according to the parameters studied”, details the resident of the Catalan hospital. After these results, Mirallas managed to make the study multicenter thanks to the participation of the Hospital of Sant Pau and the Sea Hospitalreaching up to 1500 patients studied.
A calculator to predict mortality, the next step
The next step that Mirallas and all the professionals who have helped him have set for themselves is to create a calculatorbased on the least variables possible and that it maintains the positive and accurate prediction, so that it can be extrapolated to other hospitals in order to be easy to use. “We have realized that, with these variables, the curves of the patients who they die or not in the next thirty days they separate enormously, generating a very high level of discrimination. We could already make this calculator, but we want the tool to be available to everyone and easy to use”, concludes the resident.
“The curves of patients who die or not in the next six months are greatly separated”
Starting in June, Mirallas will present his work at the ASCO Annual Meeting 2022one of the main scientific meetings in the field of oncology, after having been awarded the “Conquer Cancer Merit Award”. The main novelty that Miralles wants to achieve at work, and which will have to be after the ASCO due to lack of time, is “to create a tool that allows us to discriminate against the patient with the same prediction that we will present at the awards.”
A complete residence in the Vall d’Hebrón
Currently, Mirallas is completing his fourth year of residency at the Vall d’Hebrón Hospital, acknowledging that his experience has been fantastic. “Although Oncology It is a hard specialty on an emotional level, I feel very well. The first two years I have touched on aspects linked to the Internal Medicine, Hematology, ICU Y emergencies. Then I went to hospitalizationsand finally, in the last year, I am in queries and I have already gone through different units. I still need the mother Y lung, known as ‘big killers’ and one of the most frequent. The Vall d’Hebrón is a very good place to carry out the residency”, points out Mirallas.
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