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Prognostication in hospice care: can the palliative performance scale help?
Barbara Head1, Christine S Ritchie, Tonya M Smoot
1Program for Advanced Chronic Illness and End-of-Life Care, University of Louisville, Louisville, Kentucky 40202, USA. barbara.head@louisville.edu
Journal of Palliative Medicine
|July 5, 2005
Summary
The Palliative Performance Scale (PPS) effectively predicts survival length in hospice care. Stable PPS scores may indicate discharge readiness, while declining scores suggest patient decline toward death.
Area of Science:
- Palliative Care
- Gerontology
- Health Services Research
Background:
- Accurate illness prognostication is crucial for end-of-life care decision-making.
- Prognostic information aids in treatment planning and resource allocation.
Purpose of the Study:
- To evaluate the Palliative Performance Scale (PPS) for predicting length of stay in a home-based hospice program.
- To assess the PPS's utility in projecting patient outcomes, including death or discharge.
Main Methods:
- Retrospective review of 396 hospice patient records (January-March 2001).
- Analysis of Palliative Performance Scale (PPS) scores for predictive accuracy regarding survival and discharge.
- Inclusion of variables such as diagnosis, comorbidities, and age.
Main Results:
- PPS scores demonstrated an association with patient survival length.
- Declining PPS scores predicted patient deterioration, while stable scores suggested discharge consideration.
- The PPS showed limited discrimination between specific score ranges (30-40% vs. 50-70%).
Conclusions:
- Palliative Performance Scale (PPS) scores are linked to survival duration in hospice settings.
- The PPS can assist in determining hospice care appropriateness and patient management.