Validation of the Palliative Performance Scale in the Acute Tertiary Care Hospital Setting
- 1 February 2007
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Palliative Medicine
- Vol. 10 (1), 111-117
- https://doi.org/10.1089/jpm.2006.0125
Abstract
Background: Physicians are often asked to prognosticate patient survival. However, prediction of survival is difficult, particularly with critically ill and dying patients within the hospitals. The Palliative Performance Scale (PPS) was designed to assess functional status and measure progressive decline in palliative care patients, yet it has not been validated within hospital health care settings. Objective: This study explores the application of the PPS for its predictive ability related to length of survival. Other variables examined were correlates of symptom distress in a tertiary academic setting. Methods: Patients were assigned a score on the PPS ranging from 0% to 100% at initial consultation. Standardized symptom assessments were carried out daily, and survival was determined by medical record review and search of the National Death Index. Results: Of 261 patients seen since January 2002, 157 had cancer and 104 had other diagnoses. PPS scores ranged from 10% to 80% with 92% of the scores between 10% and 40%. Survival ranged from 0 to 30 months, with a median of 9 days. By 90 days, 83% of patients had died. Proportional hazards regression estimates showed that a 10% decrement in PPS score was associated with a hazard ratio of 1.65 (95% confidence interval [CI]: 1.42-1.92). Proportional odds regression models showed that a lower PPS was significantly associated with higher levels of dyspnea. Conclusion: The PPS correlated well with length of survival and with select symptom distress scores. We consider it to be a useful tool in predicting outcomes for palliative care patients.Keywords
This publication has 11 references indexed in Scilit:
- Is the Palliative Performance Scale a Useful Predictor of Mortality in a Heterogeneous Hospice Population?Journal of Palliative Medicine, 2005
- Prognostication in Hospice Care: Can the Palliative Performance Scale Help?Journal of Palliative Medicine, 2005
- Trends in the Aggressiveness of Cancer Care Near the End of LifeJournal of Clinical Oncology, 2004
- Validation of the Palliative Performance Scale for Inpatients Admitted to a Palliative Care Unit in Sydney, AustraliaJournal of Pain and Symptom Management, 2002
- Extent and determinants of error in doctors' prognoses in terminally ill patients: prospective cohort study Commentary: Why do doctors overestimate? Commentary: Prognoses should be based on proved indices not intuitionBMJ, 2000
- CorrespondenceJournal of Pain and Symptom Management, 1999
- A Practical Approach to Identifying Mortality‐Related Factors in Established Long‐Term Care ResidentsJournal of the American Geriatrics Society, 1998
- Survival of Medicare Patients after Enrollment in Hospice ProgramsThe New England Journal of Medicine, 1996
- Palliative Performance Scale (PPS): A New ToolJournal of Palliative Care, 1996
- Estimate of survival of patients admitted to a Palliative Care Unit: A prospective studyJournal of Pain and Symptom Management, 1992