Validation of the Palliative Prognostic Index and Palliative Prognostic Score in a Palliative Care Consultation Team Setting for Patients With Advanced Cancers in an Acute Care Hospital in Japan

Abstract

This study aims to clarify the predictive value of two prognostic prediction tools, the palliative prognostic index (PPI) and the palliative prognostic score (PaPS), in a setting of general hospital palliative care team for patients with advanced cancers in an acute care hospital in Japan. The retrospective observational study includes 247 patients for the PPI analysis and 187 patients for the PaPS analysis, all patients are older than 18 years, hospitalized with an advanced cancer, and referred to the palliative care team in an acute care hospital in Japan. The study successfully show that both the PPI and PaPS have an ability to divide patients into three groups, each with significantly different survival length (p<0.001). However, there are discrepancies in the results for predicting the length of survival between the study and the original studies conducted in hospice settings. The results suggest that although PPI and PaPS successfully divide patients into three groups with significantly different survival times, discrepancies exist in predicting the actual length of survival.

Keywords

validation prognosis predictive scale patients with cancer palliative care consultation team general hospital acute care hospital

Get full access to this article

View all access options for this article.

References

Glare

Virik

Jones

. A systematic review of physicians’ survival predictions in terminally ill cancer patients. BMJ. 2003;327(7408):195–198. doi:10.1136/bmj.327.7408.195.

Crawley

Marshall

Koenig

. Strategies for culturally effective end-of-life care. Ann Intern Med. 2002;136(9):673–679.

Christakis

Lamont

. Extent and determinants of error in doctors’ prognoses in terminally ill patients: prospective cohort study. BMJ. 2000;320(7233):469–472.

Morita

Tsunoda

Inoue

Chihara

. The palliative prognostic index: a scoring system for survival prediction of terminally ill cancer patients. Support Care. 1999;7(3):128–133.

Pirovano

Maltoni

Nanni

. A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. Italian Multicenter and Study Group on Palliative Care. J Pain Symptom Manage. 1999;17(4):231–239.

Morita

Tsunoda

Inoue

Chihara

. Improved accuracy of physicians’ survival prediction for terminally ill cancer patients using the palliative prognostic index. Palliat Med. 2001;15(5):419–424.

Tassinari

Montanari

Maltoni

. The palliative prognostic score and survival in patients with advanced solid tumors receiving chemotherapy. Support Care Cancer. 2008;16(4):359–370. doi:10.1007/s00520-007-0302-3.

Stone

Lund

. Predicting prognosis in patients with advanced cancer. Ann Oncol Off J Eur Soc Med Oncol ESMO. 2007;18(6):971–976. doi:10.1093/annonc/mdl343.

Stone

Tiernan

Dooley

. Prospective validation of the palliative prognostic index in patients with cancer. J Pain Symptom Manage. 2008;35(6):617–622. doi:10.1016/j.jpainsymman.2007.07.006.

10.

Maltoni

Nanni

Pirovano

. Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian multicenter study group on palliative care. J Pain Symptom Manage. 1999;17(4):240–247.

11.

Glare

Eychmueller

McMahon

. Diagnostic accuracy of the palliative prognostic score in hospitalized patients with advanced cancer. J Clin Oncol. 2004;22(23):4823–4828. doi:10.1200/JCO.2004.12.056.

12.

Naylor

Cerqueira

Costa-Paiva

LHS

Costa

Conde

Pinto-Neto

. Survival of women with cancer in palliative care: use of the palliative prognostic score in a population of Brazilian women. J Pain Symptom Manage. 2010;39(1):69–75. doi:10.1016/j.jpainsymman.2009.05.020.

13.

Tarumi

Watanabe

Lau

. Evaluation of the Palliative Prognostic Score (PaP) and routinely collected clinical data in prognostication of survival for patients referred to a palliative care consultation service in an acute care hospital. J Pain Symptom Manage. 2011;42(3):419–431. doi:10.1016/j.jpainsymman.2010.12.013.

14.

Anderson

Downing

Hill

Casorso

Lerch

. Palliative performance scale (PPS): a new tool. J Palliat Care. 1996;12(1):5–11.

15.

Numico

Occelli

Russi

. Survival prediction and frequency of anticancer treatment in cancer patients hospitalized due to acute conditions. Role of clinical parameters and PaP score. Support Care Cancer. 2011;19(11):1823–1830. doi:10.1007/s00520-010-1024-5.

16.

Glare

Virik

. Independent prospective validation of the PaP score in terminally ill patients referred to a hospital-based palliative medicine consultation service. J Pain Symptom Manage. 2001;22(5):891–898.

17.

Stiel

Bertram

Neuhaus

. Evaluation and comparison of two prognostic scores and the physicians’ estimate of survival in terminally ill patients. Support Care Cancer. 2010;18(1):43–49. doi:10.1007/s00520-009-0628-0.

18.

Alshemmari

Ezzat

Samir

Refaat

Alsirafy

. The palliative prognostic index for the prediction of survival and in-hospital mortality of patients with advanced cancer in Kuwait. J Palliat Med. 2012;15(2):200–204. doi:10.1089/jpm.2011.0253.

19.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994.

20.

Karnofsky

Burchenal

. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod

, ed. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press; 1949.