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The Geriatric Patient One Year After Trauma: Palliative Performance Scale Predicts Functional Outcomes.

Michele Fiorentino1, Franchesca Hwang1, Sri Ram Pentakota1

  • 1Rutgers New Jersey Medical School, 185 South Orange Avenue, Medical Science Building, Room G 594, Newark, NJ 07101.

Injury
|August 2, 2023
PubMed
Summary
This summary is machine-generated.

Pre-injury Palliative Performance Scale (PPS) in older trauma patients predicts mortality and functional status one year post-injury. A low PPS score indicates a higher risk of poor outcomes and death.

Keywords:
FrailtyGeriatric traumaGoals of careLong term outcomesSurgical Palliative care

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Area of Science:

  • Geriatric Trauma Care
  • Clinical Outcomes Research
  • Frailty Assessment

Background:

  • Frailty in trauma patients is linked to adverse outcomes like complications, mortality, and dependency.
  • Traditional outcome measures do not capture patient-centered aspects like functional status and quality of life.

Purpose of the Study:

  • To investigate if the Palliative Performance Scale (PPS) can predict one-year mortality and functional status in geriatric trauma survivors.

Main Methods:

  • Prospective observational study of trauma survivors aged 55 years and older.
  • Patients stratified into high (>70) and low (≤70) pre-injury PPS groups.
  • Functional status assessed at one year using GOSE, Euroqol-5D, and SF-36; adjusted relative risks calculated.

Main Results:

  • Low pre-injury PPS independently predicted poor functional outcome (aRR 2.64) and death (aRR 3.64) at one year.
  • Mortality was significantly higher in the low PPS group (30%) compared to the high PPS group (8%).
  • Good functional outcomes were achieved by 78% of high PPS patients versus 30% of low PPS patients.

Conclusions:

  • Pre-injury Palliative Performance Scale (PPS) is a significant predictor of one-year mortality and functional status in geriatric trauma patients.
  • Patients with a low pre-injury PPS score are more likely to experience functional decline rather than improvement.
  • Persistent pain, anxiety, and daily activity limitations were common across both PPS groups.