Assessment of the Palliative Prognostic Index in hospitalized oncologic patients treated by a palliative care team: impact of acute concomitant diseases
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Carmen Palomar-Muñoz1,*, Marina Martín-Zamorano1,*, Amparo Mogollo1, Susana Pascual-Pérez1, Inmaculada Rodríguez-Morales1 and José-Antonio Girón-González1
1Service of Internal Medicine, Palliative Care and Infectious Diseases, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz, Spain
*These authors contributed equally to this work
José-Antonio Girón-González, email: [email protected]
Keywords: cancer; palliative care; infectious diseases; survival; Palliative Prognostic Index
Received: January 16, 2018 Accepted: February 27, 2018 Published: April 10, 2018
The differential prognostic accuracy of the Palliative Prognostic Index (PPI) in hospitalized oncologic patients treated by a palliative care team according to the presence or absence of acute concomitant diseases was analyzed. All patients (n = 322) hospitalized in a palliative unit of a university hospital were included in a 2-year prospective study. PPI was determined at the time of hospital admission and discharge. Patients were grouped into two categories according to the causes of hospitalization (presence and absence of acute concomitant diseases). Metastases, PPI punctuation, refractory symptoms, and the presence of acute concomitant diseases were analyzed as survival-related factors. The absence of acute concomitant diseases and a PPI calculated at admission >4 or >6 were related with survival at 3 and 6 weeks, respectively. After hospital discharge, the accuracy of PPI was lower, decreasing the positive predictive value from 84% (PPI calculated at the time of hospital admission) to 67% (PPI calculated at the time of discharge) for survival <6 weeks. In conclusion, the impact of acute concomitant diseases on survival should be considered in prediction models for patients receiving palliative care.
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