The Vall d’Hebron Hospital in Barcelona has developed predictive model which helps oncologists determine what patients with metastatic cancer and systemic treatment, admitted from the emergency department, primarily due to pain, fever, or difficulty breathing. increased risk of death in the next 90 days.
The Promise Score tool is a web application that predicts 90-day mortality. cancer patients who arrived from the emergency department. It was developed based on an analysis of 1009 patients over 19 years of age with advanced or metastatic solid tumor
from Val d’Hebron and confirmed by 260 hospitals of Santa Creu and Sant Pau and the Hospital del Mar.The model is based on clinical and laboratory information available at the time of admission, and its primary goal is to help the medical team identify patients most likely to survive without the need for further testing and treatment. help them make decisions.
Identifying risk parameters during hospitalization helps the healthcare team guide treatment, improve the quality of care, and avoid unnecessary procedures. situations where there is no clear benefit from treatmentin addition to reducing costs.
“The model we developed has strong predictive power for patients with favorable prognosiswith which we can rely with greater confidence on aggressive therapeutic interventions,” explains Dr. Oriol Mirallas, assistant in the medical oncology service of the Val d’Hebron hospital and researcher at the molecular therapeutics department of the UITM-CaixaResearch in Val d’Hebron. Hebron, Hebron Institute of Oncology (VHIO).
This tool could spare patients at high risk of mortality from invasive treatments that will not improve their prognosis, reducing unnecessary suffering. “It has been proven that nutritional support and palliative care
focused on the community, improving the quality of life and survival of patients at this advanced stage of the disease,” emphasizes Dr. Joan Carles, head of the hospital’s department and head of the genitourinary system, central nervous system, sarcoma and tumors of unknown origin.The app takes into account that high levels of LDH (tumor load), neutrophils (inflammation) and albumin (a protein indicating a patient’s nutritional status) in a blood test are associated with a worse prognosis. It also evaluates ECOG functional status, latest TAC reports for rate the answer for treatment and disease progression, stage of the tumor (spread) and the mood of the patient.
If the “Promise Score” indicates availability high risk, priority will be palliative careand if the risk is low, it interprets that “you need to do everything you can” by intensifying medical treatment. Likewise, Mirallas emphasized that the prognostic model is another tool in guiding treatment and that planning the final therapeutic strategy “will always be done by consensus” with patients, their families and the oncologist.
application The website is accessible to oncologists and the Barcelona Hospital Clinic will continue to “work to improve and validate the ‘promised assessment’ in other populations and contexts.” extend it to other centers in an international prospective study.
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