The Palliative Prognostic Index (PPI) can be used to predict short term mortality in terminally ill cancer patients. The authors are from Seirei Hospice in Shizuoka, Japan.
Parameters:
(1) Palliative Performance Scale (a modified Karnofsky scale, with values from 100 to 0, with 0 indicating death)
(2) oral intake
(3) edema
(4) dyspnea at rest
(5) delirium
|
Parameter |
Finding |
Points |
|
Palliative Performance Scale |
>= 60 |
0 |
|
|
30 – 50 |
2.5 |
|
|
10 - 20 |
4 |
|
oral intake |
normal |
0 |
|
|
moderately reduced |
1 |
|
|
severely reduced |
2.5 |
|
edema |
absent |
0 |
|
|
present |
1 |
|
dyspnea at rest |
absent |
0 |
|
|
present |
3.5 |
|
delirium |
absent |
0 |
|
|
present |
4 |
Palliative Prognostic Index (PPI) =
= SUM(points for the 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score, the more serious the illness.
|
PPI |
Group |
Mean Survival Training Sample |
Mean Survival Testing Sample |
|
<= 2.0 |
A |
155 +/- 20 days |
134 +/- 11 days |
|
2.5 to 4.0 |
B |
89 +/- 7.7 days |
89 +/- 7 days |
|
> 4.0 |
C |
18 +/- 2.9 days |
23 +/- 2.9 days |
Performance of a PPI > 6 to predict 3 week survival:
(1) The sensitivity was 80% and specificity 85%.
(2) The positive predictive value was 71% and negative predictive value 90%.
(3) The overall accuracy was 80%.
Performance of PPI > 4 to predict 6 week survival:
(1) The sensitivity was 80% and specificity 77%.
(2) The positive predictive value was 76% and negative predictive value 81%.
(3) The overall accuracy was 79%.
Purpose: To predict survival in a terminal ill patient using the Palliative Prognostic Index (PPI).
Specialty: Hematology Oncology, Surgery, general
Objective: risk factors, severity, prognosis, stage
ICD-10: C80.9,
