Prognostication in hospice care: can the palliative performance scale help?
Prognostication in hospice care: can the palliative performance scale help?
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DOI：
10.1089/jpm.2005.8.492
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发表时间：
2005-06-01
影响因子：
2.8
通讯作者：
Smoot, Tonya M
中科院分区：
文献类型：
--
作者：
Head, Barbara;Ritchie, Christine S;Smoot, Tonya M
背景：对疾病轨迹的准确预测为临终关怀提供了多种益处。预后信息有助于对正在进行的治疗做出更现实的决策，促进对特定干预措施的风险-收益考虑，并有助于适当利用卫生保健服务。目的：姑息表现量表(PPS)已被用作衡量姑息治疗中功能状态的工具。这项研究探讨了PPS在家庭临终关怀计划中作为预测死亡或出院前住院时间的应用。方法：回顾2001年1月1日至2001年3月31日期间大型社区临终关怀计划的396名患者的记录。评估PPS评分与临终关怀生存时间和临终关怀出院相关的预测能力。其他变量包括诊断、合并症的存在和年龄。结果：PPS评分与生存时间相关。消极变化的评分预示着患者死亡的下降，而随着时间的推移，稳定的PPS评分导致了出院考虑。结论：PPS评分与患者在临终关怀项目中的生存时间有关，可用于临终关怀适宜性的评估。
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.