Background: Accurate prognostication of the trajectory of an illness provides multiple benefits
in end-of-life care. Prognostic information facilitates more realistic decision making regarding
ongoing treatment, fosters risk–benefit considerations of specific interventions, and
contributes to appropriate utilization of health care services.
Objective: The Palliative Performance Scale (PPS) has been used as a tool for measurement
of functional status in palliative care. This study explores the application of the PPS as a tool
for projecting length of stay until death or discharge in a home-based hospice program.
Methods: Records of 396 patients admitted to a large community-based hospice program
between January 1, 2001, and March 31, 2001, were reviewed. PPS scores were evaluated for
their predictive ability related to length of hospice survival and consideration for hospice discharge.
Other variables analyzed included diagnosis, presence of comorbidities, and age.
Results: PPS scores were associated with length of survival. Negative-change scores were
predictive of patient decline toward death, while stable PPS ratings over time resulted in discharge
consideration. The tool as used by this hospice was not highly discriminating between
the 30% to 40% scores or the 50% to 70% scores.
Conclusion: The PPS scores are associated with patient length of survival in a hospice program
and can be used in evaluating hospice appropriateness.
