Use of palliative performance scale in end-of-life prognostication
Use of palliative performance scale in end-of-life prognostication
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DOI：
10.1089/jpm.2006.9.1066
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发表时间：
2006-10-01
影响因子：
2.8
通讯作者：
Kuziemsky, Craig
中科院分区：
文献类型：
--
作者：
Lau, Francis;Downing, G. Michael;Kuziemsky, Craig
背景：目前的文献表明，临床医生在估计姑息治疗患者的生存时间时并不准确。有报告的研究中，姑息性能量表（PPS）被用作预测这些患者生存的预后工具。然而，他们的研究结果是不同的存在不同的PPS生存配置文件和显着的covariates.Objective：本研究探讨使用PPS作为估计生存时间的姑息治疗单位的患者的生命限制性疾病的一个辅助工具。将这些结果与早期研究的PPS生存曲线和协变量进行比较。研究方法：这是一项回顾性队列研究，对2000年3月3日至2002年8月9日期间收治的733例姑息治疗患者的入院PPS评分进行了生存模式检查。生存的其他预测因素包括年龄，性别，和diagnosis.Results：研究结果显示，入院PPS评分是一个强有力的预测生存的患者已经确定为姑息，沿着性别和年龄，但诊断是没有显着相关的生存。我们还发现，PPS 10%到PPS 50%的分数导致不同的生存曲线，男性患者的生存率始终低于女性，无论PPS score.Conclusion：我们的研究结果有所不同，从早期的研究，建议存在三个不同的PPS生存曲线或乐队，诊断和非癌症作为显着的协变量。这种差异可能归因于所涉及患者人群的规模和特征，对更大患者样本的进一步分析可能有助于阐明PPS在预后中的应用。
Background: Current literature suggests clinicians are not accurate in prognostication when estimating survival times of palliative care patients. There are reported studies in which the Palliative Performance Scale (PPS) is used as a prognostic tool to predict survival of these patients. Yet, their findings are different in terms of the presence of distinct PPS survival profiles and significant covariates.Objective: This study investigates the use of PPS as a prognostication tool for estimating survival times of patients with life-limiting illness in a palliative care unit. These findings are compared to those from earlier studies in terms of PPS survival profiles and covariates. Methods: This is a retrospective cohort study in which the admission PPS scores of 733 palliative care patients admitted between March 3, 2000 and August 9, 2002 were examined for survival patterns. Other predictors for survival included were age, gender, and diagnosis.Results: Study findings revealed that admission PPS score was a strong predictor of survival in patients already identified as palliative, along with gender and age, but diagnosis was not significantly related to survival. We also found that scores of PPS 10% through PPS 50% led to distinct survival curves, and male patients had consistently lower survival rates than females regardless of PPS score.Conclusion: Our findings differ somewhat from earlier studies that suggested the presence of three distinct PPS survival profiles or bands, with diagnosis and noncancer as significant covariates. Such differences are likely attributed to the size and characteristics of the patient populations involved and further analysis with larger patient samples may help clarify PPS use in prognosis.