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Accuracy and usefulness of the Palliative Prognostic Index in a community setting
Emmanuelle Belanger1, Danielle Tetrault2, Golda Tradounsky3
1Research Scientist, Department of Social and Preventive Medicine, Public Health Research Institute (IRSPUM), Université de Montreal.
Purpose:
In a community setting characterised by scarce inpatient palliative care resources, a precise prognosis could help determine which patients should be prioritised for end-of-life admission.
Aim:
The aim of this study was to assess the validity of the Palliative Prognostic Index (PPI) and to determine whether it is a helpful tool for nurses to administer as part of the admission protocol in the palliative care service of a community hospital.
Results:
The PPI was a moderately accurate prognostic tool when assessing the frequency of 14-day overstay; 81% of patients died within 14 days of their expected prognosis. Based on sensitivity and specificity, the accuracy of the prognoses was acceptable for the 6-week prognosis group (80%), and poor for the 3-week prognostic group (53%). The tool was easy to administer by the admission nurse receiving referrals.
Conclusion:
A nurse-administered and minimally-invasive prognostic tool was helpful in this context.
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