Serial Palliative Performance Scale Assessment in a University General Hospital: A Pilot Study.

Autor:	de Medeiros RB; Department of Internal Medicine, Federal University of Santa Catarina, University Hospital Polydoro Ernani de São Thiago , Florianópolis, Brazil ., Stamm AMNF; Department of Internal Medicine, Federal University of Santa Catarina, University Hospital Polydoro Ernani de São Thiago , Florianópolis, Brazil ., Moritz RD; Department of Internal Medicine, Federal University of Santa Catarina, University Hospital Polydoro Ernani de São Thiago , Florianópolis, Brazil ., Freitas PF; Department of Internal Medicine, Federal University of Santa Catarina, University Hospital Polydoro Ernani de São Thiago , Florianópolis, Brazil ., Kretzer LP; Department of Internal Medicine, Federal University of Santa Catarina, University Hospital Polydoro Ernani de São Thiago , Florianópolis, Brazil ., Gomes JV; Department of Internal Medicine, Federal University of Santa Catarina, University Hospital Polydoro Ernani de São Thiago , Florianópolis, Brazil .
Jazyk:	angličtina
Zdroj:	Journal of palliative medicine [J Palliat Med] 2018 Jun; Vol. 21 (6), pp. 842-845. Date of Electronic Publication: 2018 Jan 19.
DOI:	10.1089/jpm.2017.0412
Abstrakt:	Background: Serial Palliative Performance Scale (PPS) assessments may predict functional decline and prognosis in cancer and noncancer patients and help with end-of-life decision making. Objective: To evaluate the functional status of using serial PPS assessments of patients being assisted in collaboration with the palliative care team (PCT). Design: Prospective cohort pilot study. Measurements: The sample consisted of 64 cancer and noncancer inpatients being assisted in collaboration with the PCT during the period from 2012 to 2016 (included 12 months). Patients' PPS scores were assessed in three sequential stages: prehospital, first PCT assessment, and outcome (discharge, transference to another unit or death). Functional performance was classified in categories as stable (PPS scores between 70% and 100%), transitional (PPS scores between 40% and 60%), and end of life (PPS scores between 10% and 30%). Results: The mean PPS score during the three assessment stages (respectively, 60.5%, 38.9%, and 25.9%) was significantly different (p < 0.001). Cancer patients had higher PPS scores than noncancer patients; however, both groups exhibited a functional decline along the hospital stay. In both groups there was a negative correlation between the time frame between the different assessment stages and PPS scores (respectively, Pearson -0.4 and -0.6; p < 0.01). The survival curve of the first palliative assessment stage demonstrated earlier death in patients in the end-of-life category. Conclusion: Serial PPS assessments are feasible and predicted functional decline in cancer and noncancer patients in this sample. Cancer patients exhibited higher initial functional scores but both cancer and noncancer patients declined in functionality along hospitalization. Earlier deaths occurred in the terminal PPS category than in the transitional PPS category.
Databáze:	MEDLINE
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