Palliative Performance Scale and survival in patients with cancer and non-cancer diagnoses needing a palliative care consultation: a retrospective cohort study

Abstract

Background Palliative Performance Scale (PPS) has been frequently used to estimate the survival time of palliative care patients. The objective was to determine the associations between the PPS and survival time among cancer and non-cancer patients in Thailand. Methods This is a retrospective cohort study. All in-patient adults who received a palliative care consultation at Chiang Mai University Hospital between 1 July 2018 to 31 July 2019 were included in the study and were followed-up until 26 June 2020. The Palliative Performance Scale was assessed using the validated Thai-Palliative Performance Scale for Adults. Survival analysis was used to determine the association between the Palliative Performance Scale and survival time among cancer and non-cancer patients. Results Out of 407 patients, 220 were male (54.1%). There were 307 cancer patients (75.4%) and 100 non-cancer patients (24.6%). The PPS and survival time in cancer patients were significantly correlated. Cancer patients with PPS 10, 20, 30, 40–60, and 70–80% had a median survival time of 2, 6, 13, 39, and 95 days, respectively. Non-cancer patients with PPS 10, 20, and 30% had a median survival time of 8, 6, and 24 days, respectively. Conclusions While useful for estimating survival time for cancer patients, other factors should be taken into account in estimating the survival time for non-cancer patients.

End-of-life use of antibiotics: a survey on how doctors decide

“…Table 1 -Categories of clinical vignettes and situations used to evaluate the decisionmaking on the use of antibiotics by doctors who provide in palliative care PPS: Palliative Performance Scale (Prompantakorn et al, 2021), GOLD D: score associated with more symptoms and poor lung function (Cui et al, 2019) Vignette Disease…”

“…PPS: Palliative Performance Scale(Prompantakorn et al, 2021); GOLD D: score associated with more symptoms and poor lung function(Cui et al, 2019), NA: not applicable…”

The use of Palliative Performance Scale as the Sole Prognostication Tool among Patients Transferred Under Palliative Care: A Single Institution’s Experience in Qatar

“…Advanced cancer patients may have a relatively good performance status for a long period of time, then experience rapid deterioration until death. [2] Therefore, reaching an accurate prognostication for advanced cancer patients is a crucial step to better coordinating treatment plans between patients, families, and the medical team. This speci c information helps patients and their families to bring closure to life matters, such as nancial, social, or emotional aspects.…”

“…[4] The stage and progression of cancer in uence survival time; however, end-of-life prognostication in palliative care is extremely challenging, even for the most experienced clinicians. [2] [3] The complexity of interchangeable factors among patients, families, and the health system in uences clinicians' predictions of end-of-life [4] , yet cancer patients with advanced disease as well as their families expect that their primary physicians should provide them with the most accurate prognosis possible, especially when there is uncertainty related to the bene ts of further anticancer treatment. [5] Thereby, it is highly recommended to incorporate clinical perception with a validated and reliable prognostic tool.…”

Comorbidity and dependence jointly indicate the need for palliative care in nursing home residents

“…Identifying nursing home residents requiring palliative care is a pre-requisite to their effective access to palliative care. Existing tools to identify palliative situations are either derived from prognosis estimation (4,5) or from multimorbidity evaluation (6) and are seldom specific to nursing home residents (7). But existing identification tools lack sensitivity and often identify nursing home residents in very advanced or terminal stages, when care planning is limited to short-term goals of care, whereas earlier identification would be required in nursing home residents often presenting terminal declines over several years (8).…”