What is a prognosis?

Screening and Diagnosis

Every diagnosis has a prognosis. The diagnosis of any disease (tuberculosis, acquired immunodeficiency syndrome, chickenpox), 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 stated by how the patient is now compared to the expected outcome: For example, the situation may be critical now, but if the patient continues improving, he or she will have a favorable outcome.

A numerical prognosis is often given in the form of a number scale of 1 to 10, or 1 to 100. The health care provider will state if the number 1 is the best case or the worst case in each scenario. A numerical prognosis may also be explained by using percentages. For example, 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 long-term prognosis is 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 of 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, the patient can help to create a more favorable prognosis.

Early detection of any condition, disease, or illness will help to improve the odds of producing 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 earlier in life to perform monthly self-breast examinations and to seek routine annual breast exams by their health care provider. 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 is not 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 medical online sources or books pertaining to a particular situation.

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 1 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 4. Stage 4 cancers have spread to other organs and may be difficult to control or stop. Stage 4 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 toward reoccurring.

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, Tai Chi Chuan, breathing and relaxation techniques, and a positive mental outlook.

The Morbidity and Mortality Weekly Report (MMWR) 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. By knowing a prognosis and understanding its recovery rate, a patient can make an informed decision regarding a treatment plan.

Bibliography

American Heart Association. “Cardiac Arrest.” American Heart Association, February 2, 2013.

Centers for Disease Control and Prevention. "MMWR: Summary of Notifiable Diseases." Morbidity and Mortality Weekly Report, May 31, 2012.

Centers for Disease Control and Prevention. "MMWR Weekly: Current Volume (2013)." Morbidity and Mortality Weekly Report, June 21, 2013.

Morra, Marion, and Eve Potts. Choices: The Most Complete Source Book for Cancer Information. 4th ed. New York: HarperCollins, 2003.

Seaman, Andrew M. "Patient Communication Has Room to Grow." Reuters Health Information. MedlinePlus, May 27, 2013.