Prognosis
Prognosis refers to the forecasted outcome of a patient's condition following a diagnosis, applicable across various diseases, chronic conditions, injuries, and medical emergencies. It can be conveyed through various means, including descriptive terms, numerical scales, charts, and percentages, indicating the likelihood of recovery or survival. A prognosis is typically categorized as favorable or poor, with additional descriptors such as excellent, fair, or bleak reflecting the expected outcome. Factors influencing prognosis include the type of illness, patient health history, lifestyle habits (such as diet, exercise, and substance use), age, and socio-economic status. Early detection and intervention significantly enhance the chances of a favorable prognosis, making regular check-ups and awareness of health conditions crucial. Patient education plays an essential role in improving long-term prognoses, as understanding one's health condition can lead to better management and treatment adherence. Treatment plans can also affect prognosis, as various therapies may be employed to enhance recovery chances. Overall, prognosis serves as a vital guide for patients and healthcare providers in navigating treatment decisions and expected health outcomes.
Prognosis
Also known as: Future outlook
Anatomy or system affected: All
Definition: A medically educated guess that helps determine the probability of a patient’s final outcome concerning a disease, illness, injury, or affliction. A prognosis may refer to a patient’s quality of life, quantity of life, or both.
Screening and Diagnosis
Every diagnosis has a prognosis. The diagnosis of any disease (e.g., tuberculosis; acquired immunodeficiency syndrome, or AIDS; chicken pox), any chronic condition (asthma, vitiligo, alopecia, cardiomegaly, multiple sclerosis), any cancer (melanoma, osteosarcoma, breast cancer, testicular cancer, lymphoma), any reaction to a bite or sting (rabies, spider or wasp venom, scabies), any medical emergency (gunshot wound, stabbing, motor vehicle accident), or any symptom or medical circumstance (hypothermia, dizziness, pregnancy) will create the need for a prognosis.
A prognosis may be described in words, numbers, charts, percentages, or graphs. If the chances of surviving or eliminating a given medical circumstance are good, then the prognosis is termed favorable. If not, then it may be said that the prognosis is poor or that the prognosis has become not favorable. Other possible words include excellent, good, fair, unfavorable, not good, failing, bleak, dim, or taking a turn for the worse. A prognosis may also be expressed in terms of how the patient is now compared to the expected outcome. For example, the situation may be critical now, but if the patient continues improving, they will have a favorable outcome.
A numerical prognosis is often given in the form of a number scale of one to ten, or one to one hundred. The health-care provider will state if the number one is the best case or the worst case in each scenario. A numerical prognosis may also be explained by using percentages—for example, by saying that the patient has a 25 percent chance that the disease will return or, conversely, a 75 percent chance that the disease will disappear. An example of a long-term prognosis is to say that the patient’s five-year outlook has a 90 percent chance of a full recovery.
Future Outlook
Many factors are taken into consideration when determining a prognosis. A certain factor may help improve a prognosis favorably, while others may affect a prognosis unfavorably. The following factors all influence a patient’s prognosis: type of disease or illness, type of injury or affliction, nutritional habits, weight factor or obesity, current medications, exercise, alcohol consumption, smoking, work environment, care or neglect of general overall health, previous health history, family history, race, gender, sexual orientation, age, financial status, education, religion, and culture. For example, by avoiding alcohol consumption and avoiding smoking, a patient can help create a more favorable prognosis.
Early detection of any condition, disease, or illness will help improve the odds of a more favorable prognosis. For example, according to the American Cancer Society, early breast cancer detection saves thousands of lives each year. This information can encourage women to perform monthly breast self-examinations and seek routine annual breast exams by their health-care provider earlier in life. Routine physicals are also helpful in finding afflictions such as high blood pressure early so that patients may be given medications to help improve the long-term prognosis for a healthier life.
Early intervention also includes the point at which care is first administered, which can be a determining factor in the favorability of a prognosis. For example, if a patient has a heart attack and cardiopulmonary resuscitation (CPR) is administered within the first three minutes, then the patient will have a more favorable outlook for a good recovery (a better prognosis). If the patient does not receive any CPR until ten minutes after the heart attack, however, then the prognosis will not be very good in terms of the patient surviving. In addition, the more severe an injury that may include extensive blood loss, the lower the chances of survival.
Understanding the Disease or Condition
Patient education is beneficial in helping produce a more favorable long-term prognosis for any patient. This education may come in the form of pamphlets or books dispensed by the health-care provider. Patients may also educate themselves through online medical sources or books pertaining to a particular situation. Caution should be used when reading information from the internet as the source of much online information is often questionable.
In general, certain diseased or traumatized organs tend to have a less favorable prognosis, such as the liver, lungs, kidneys, ovaries, testicles, and pancreas. Certain diseases have their own stages of prognosis. For example, cancers that are detected while the patient is in stage one are considered more easily treatable, and often the prognosis is more favorable if the disease is treated early versus cancers that are found in stage four. Stage four cancers have metastasized or spread to other organs and may be difficult to control or stop. Stage four cancers often have a prognosis of not favorable (more likely resulting in death); if treated at this later stage, these cancers also have a greater tendency to recur.
Treatment Plans
Every treatment plan, therapy, or medication has the potential to alter a prognosis. Some alternative therapies that may be incorporated into treatment to help improve a prognosis include acupressure, acupuncture, herbal remedies, meditation, guided imagery, massage therapy, laughter, biofeedback, chiropractic, energy healing, yoga, breathing and relaxation techniques, and positive mental outlook.
The Morbidity and Mortality Weekly Report (MMWR), put out by the Centers for Disease Control and Prevention, analyzes data and calculates statistics from every death that occurs. These lists can help the health-care provider determine a treatment plan and a prognosis. A patient can make an informed decision by knowing a prognosis and understanding its recovery rate, regarding a treatment plan.
Bibliography
“About Cardiac Arrest.” American Heart Association, www.heart.org/HEARTORG/Conditions/More/CardiacArrest/About-Cardiac-Arrest‗UCM‗307905‗Article.jsp. Accessed 14 Aug. 2023.
"American Cancer Society Recommendations for the Early Detection of Breast Cancer." American Cancer Society, 14 Jan. 2022, www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Accessed 14 Aug. 2023.
“Morbidity and Mortality Weekly Report (MMWR).” CDC, 20 July 2023, www.cdc.gov/mmwr/index.html. Accessed 26 July 2023.
Morra, Marion, and Eve Potts. Choices. 4th ed., HarperCollins, 2003.
"Notifiable Diseases and Mortality Tables." Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, 15 Nov. 2016, www.cdc.gov/mmwr/mmwr‗nd/nd‗data‗tables.html. Accessed 13 Jan. 2017.
Seaman, Andrew M. "Patient Communication Has Room to Grow: Studies." Reuters, 27 May 2013, www.reuters.com/article/us-patient-communication-idUSBRE94Q0KN20130527. Accessed 13 Jan. 2017.