Use of the Palliative Performance Scale (PPS) for End-of-Life Prognostication in a Palliative Medicine Consultation Service

Francis Lau*, Vincent Maida, Michael Downing, Mary Lesperance, Nicholas Karlson, Craig Kuziemsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

80 Citations (Scopus)

Abstract

This study examines the use of the Palliative Performance Scale (PPS) in end-of-life prognostication within a regional palliative care program in a Canadian province. The analysis was done on a prospective cohort of 513 patients assessed by a palliative care consult team as part of an initial community/hospital-based consult. The variables used were initial PPS score, age, gender, diagnosis, cancer type, and survival time. The findings revealed initial PPS to be a significant predictor of survival, along with age, diagnosis, cancer type and site, but not gender. The survival curves were distinct for PPS 10%, 20%, and 30% individually, and for 40%-60% and ≥70% as bands. This is consistent with earlier findings of the ambiguity and difficulty when assessing patients at higher PPS levels because of the subjective nature of the tool. We advocate the use of median survival and survival rates based on a local cohort where feasible, when reporting individual survival estimates.

Original languageEnglish
Pages (from-to)965-972
Number of pages8
JournalJournal of Pain and Symptom Management
Volume37
Issue number6
DOIs
Publication statusPublished - Jun 2009
Externally publishedYes

Keywords

  • end of life
  • palliative care
  • Palliative Performance Scale
  • prognostication
  • survival estimates
  • survival prediction

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