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Using the Palliative Performance Scale to provide meaningful survival estimates
Francis Lau1, Michael Downing, Mary Lesperance
1School of Health Information Science, University of Victoria, British Columbia, Canada. fylau@uvic.ca
Journal of Pain and Symptom Management
|January 28, 2009
Summary
The Palliative Performance Scale (PPS) significantly predicts survival in advanced cancer patients receiving palliative care. Higher PPS scores correlate with longer survival times, aiding clinical discussions.
Area of Science:
- Palliative Care Medicine
- Oncology
- Biostatistics
Background:
- Growing knowledge on survival prediction in advanced cancer patients using the Palliative Performance Scale (PPS).
- Existing literature often focuses on disease, gender, and care location, with less emphasis on clinical applicability.
- Need for clinically meaningful application of survival prediction tools in palliative care settings.
Purpose of the Study:
- To evaluate the Palliative Performance Scale (PPS) as a predictor of survival in advanced cancer patients.
- To explore methods for assisting in the estimation of survival times in palliative care.
- To assess the clinical utility of survival prediction in discussions with patients and families.
Main Methods:
- Analysis of a 13-year database of initial PPS scores from 6066 patients.
- Inclusion of patients assessed by the Victoria Hospice palliative care team in home or palliative care unit settings.
- Exploration of survival time distributions, life expectancy tables, and survival nomograms.
Main Results:
- Reaffirmation of PPS as a significant predictor of survival.
- Demonstration of increasing survival times associated with higher PPS levels.
- Evaluation of survival time distributions, life expectancy tables, and survival nomograms as potential tools.
Conclusions:
- The Palliative Performance Scale (PPS) is a valuable tool for predicting survival in advanced cancer patients.
- Further research is needed on refining survival curve analysis for greater clinical utility.
- Enhanced methods are required to identify patients living "longer than expected" or dying "sooner than expected" for improved patient-family discussions.
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