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KMID : 0856920170200040235
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Journal of Hospice and Palliative Care
2017 Volume.20 No. 4 p.235 ~ p.241
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Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer
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Oh Jee-Hye
Lee Yong-Joo
Seo Min-Seok
Yoon Jo-Hi
Kang Chung
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Abstract
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Purpose: The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer.
Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital’s hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). “Change on D3” was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival.
Results: The changes in scores were associated with survival. A score change of ＞30% yielded a hazard ratio for death of 2.66 (95% CI 2.19∼3.22), compared to a score change of ≤30%. PPS of ≤30 on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38∼2.02) compared to PPS of ＞30.
Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.
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KEYWORD
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Palliative care, Hospice care, Prognosis, Survival
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