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http://dx.doi.org/10.14475/kjhpc.2017.20.4.235

Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer  

Oh, Jee Hye (Department of Family Medicine, The Catholic University of Korea College of Medicine)
Lee, Yong Joo (Department of Family Medicine, The Catholic University of Korea College of Medicine)
Seo, Min Seok (Department of Family Medicine, The Catholic University of Korea College of Medicine)
Yoon, Jo Hi (Department of Family Medicine, The Catholic University of Korea College of Medicine)
Kim, Chul Min (Department of Family Medicine, The Catholic University of Korea College of Medicine)
Kang, Chung (Department of Family Medicine, The Catholic University of Korea College of Medicine)
Publication Information
Journal of Hospice and Palliative Care / v.20, no.4, 2017 , pp. 235-241 More about this Journal
Abstract
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 ${\leq}30%$. PPS of ${\leq}30$ 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.
Keywords
Palliative care; Hospice care; Prognosis; Survival;
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