Palliative Prognostic Index (PPI)
Predicts survival in terminally ill patients based on five criteria.
Refer to the text below the calculator for more information about the PPI.
The PPI predicts survival in terminally ill patients based on the score in the Palliative Performance Scale, and four other clinical symptoms: oral intake, oedema, dyspnea at rest and delirium.
PPI results range from 0 to 15. Moreover, in the original study when a PPI of more than 6 was adopted as a cut-off point, 3 weeks' survival was predicted with a sensitivity of 80% and a specificity of 85%.
Alternatively, when a PPI of more than 4 was used as a cut-off point, 6 weeks' survival was predicted with a sensitivity of 80% and a specificity of 77%.
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About Palliative Prognostic Index
The PPI predicts survival in terminally ill oncologic patients based on the score in the Palliative Performance Scale, and four other clinical symptoms: oral intake, oedema, dyspnea at rest and delirium:
- Palliative Performance Scale: 10-20 (+4), 30-50 (+2.5),>60 (0);
- Oral Intake: Severely Reduced (< mouthfuls) (+2.5), Moderately Reduced (> mouthfuls) (+1), Normal (0);
- Oedema: Present (+1), Absent (0);
- Dyspnea at rest: Present (+3.5), Absent (0);
- Delirium: Present (+4), Absent (0).
The PPI can acceptably predict whether or not a patient will survive >3 or >6 weeks.
PPI results range from 0 to 15 with the indication that scores greater than 6.0 survival is less than three weeks (Sensitivity - 80%; Specificity - 85%).
The existence of concomitant diseases has not been taken into account in the building of the majority of survival prognostic scores, although acute concomitant diseases can impact scoring and survival.
About the original study
Morita et al. developed a validated scoring system for survival prediction following a retrospective cohort study, on two independent series of terminally ill oncologic patients.
In the training set (355 assessments on 150 patients) the Palliative Prognostic Index was applied. In the testing sample (233 assessments on 95 patients) the predictive values were examined.
When a PPI of more than 6 was adopted as a cut-off point, 3 weeks' survival was predicted with a sensitivity of 80% and a specificity of 85%. Alternatively, when a PPI of more than 4 was used as a cut-off point, 6 weeks' survival was predicted with a sensitivity of 80% and a specificity of 77%.
References
Original reference
Morita T, Tsunoda J, Inoue S, Chihara S. The palliative prognostic index: a scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer 1999; 7: 128-33.
Validation
Stone CA, Tiernan E, Dooley BA. Prospective validation of the palliative prognostic index in patients with cancer. J Pain Symptom Manage. 2008;35(6):617-22.
Other references
Kao CY, Hung YS, Wang HM, Chen JS, Chin TL, Lu CY, Chi CC, Yeh YC, Yang JM, Yen JH, Chou WC. Combination of initial palliative prognostic index and score change provides a better prognostic value for terminally ill cancer patients: a six-year observational cohort study. J Pain Symptom Manage. 2014;48(5):804-14.
Specialty: Palliative Care
Objective: Screening
Type: Index
No. Of Items: 5
Year Of Study: 1999
Abbreviation: PPI
Article By: Denise Nedea
Published On: May 4, 2020 · 12:00 AM
Last Checked: May 4, 2020
Next Review: May 4, 2025