Palliative Performance Scale predicts mortality in cardiac intensive care unit

Area of Science:

• Cardiology
• Critical Care Medicine
• Geriatrics

Background:

• The growing elderly population presents challenges in managing critically ill cardiac patients with multiple comorbidities.
• The Palliative Performance Scale (PPS), originally for cancer patients, has potential but is understudied in Cardiac Intensive Care Units (CICUs).

Purpose of the Study:

• To evaluate the Palliative Performance Scale (PPS) as a prognostic tool for in-hospital and 1-year all-cause mortality in CICU patients.

Main Methods:

• A prospective, observational study of 1131 CICU patients was conducted.
• Patients were grouped by admission PPS score (≤70 vs >70).
• Multivariable regression and survival analysis were used to assess mortality predictors and model performance.

Main Results:

• Patients with PPS ≤70 had significantly higher in-hospital (17.7% vs 3.3%) and 1-year (37.0% vs 9.8%) mortality.
• PPS was an independent predictor of mortality, alongside age and SOFA score.
• Models showed good discriminatory performance (AUCs 0.841-0.862) and calibration.

Conclusions:

• The Palliative Performance Scale (PPS) is a reliable and independent predictor of mortality in CICU patients.
• Integrating PPS into clinical practice can improve risk stratification and guide decision-making for high-risk cardiac patients.