Recalibración del Palliative Prognostic Index en pacientes con enfermedades médicas avanzadas

Nieto-Martín, María Dolores; Bernabéu-Wittel, Máximo; Vila, Laura De la Higuera; Rufete, Antonia Mora; Franco, B. Barón; Baturone, Manuel Ollero

doi:10.1016/j.rce.2013.04.007

Cited by 16 publications

(11 citation statements)

References 24 publications

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“…Also, significant relationships were found between the mortality at 6 months and the "presence of persistent symptoms" [5] and between the "PPI recalibrated for advanced medical conditions" [8] and the "PPS" [9]. Mercadante et al [11] show that symptoms such as loss of appetite, dyspnea, delirium, fatigue, and drowsiness, assessed by the instruments that comprise our models, also exhibit prognostic value.…”

Section: Discussionmentioning

confidence: 72%

“…The study objective was to compare the prognostic utility in nursing homes of two prognostic models of 6-month survival based on the PPI or PPS instruments and palliative needs indicators, finding that both presented a good fit for predicting the prognosis at 6 months. Also, significant relationships were found between the mortality at 6 months and the "presence of persistent symptoms" [5] and between the "PPI recalibrated for ad-vanced medical conditions" [8] and the "PPS" [9]. Mercadante et al [11] show that symptoms such as loss of appetite, dyspnea, delirium, fatigue, and drowsiness, assessed by the instruments that comprise our models, also exhibit prognostic value.…”

Section: Discussionmentioning

confidence: 73%

“…The scores are associated with 1-year mortality rates that oscillate between 12 and 85%. − PPI recalibrated for advanced medical conditions [8]: Contemplates a series of symptoms and parameters, including the PPS, offering scores from 0 to 15 points, obtaining four strata for risk of dying at 6 months ranging from 13% for scores of 0 to 68% for scores of 10 or more. − PPS [9]: Establishes eleven categories of functionality, divided into intervals of 10%, ranging from 100% (free ambulation and healthy) to 0% (death).…”

Section: Study Variablesmentioning

confidence: 99%

“…One of the most widely used prognostic tools in the Spanish healthcare system is the Palliative Prognostic Index (PPI) [8]. The PPI is a quantitative scale validated to predict mortality in terminal oncological patients at 3 or 6 weeks that was recalibrated by Nieto Martín et al [8] for use in people with advanced medical conditions at 6 months.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Models Associated with 6-Month Survival of Patients Admitted to Nursing Homes

et al. 2018

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Background: Health status and the needs presented by people admitted to nursing homes make it necessary to contemplate aspects such as prognosis to offer quality palliative care. Objective: To compare the prognostic utility in nursing homes of two prognostic models of 6-month survival based on the Palliative Prognostic Index (PPI) or Palliative Performance Status (PPS) instruments and palliative needs indicators. Methods: A longitudinal prospective observational and analytical cohort study of survival and prognostic models in 88 patients with palliative needs (assessed by the NECPAL-ICO-CCOMS^©) from an Andalusian (Spain) nursing home was performed. Sociodemographic and clinical variables were assessed, and 6 months later, in September 2017, survival was checked. Multiple logistic regression analysis was performed using the R-Commander program (version 3.2.2). Results: Two models of the logistic regression analysis met the fit criteria. The two models combined the Surprise Question, the presence of persistent symptoms, and the clinical indicators of severity from the NECPAL tool, in addition to the Charlson Comorbidity Index, and varied only in terms of the latter variable, including the PPI in the first model and the PPS in the second. In the first model, significant associations were identified between 6-month survival and the persistent symptoms variable (OR = 7.78, p = 0.025, 95% CI = 1.45–60.92) and PPI (OR = 1.94, p < 0.001, 95% CI = 1.21). In the second model, 6-month survival was also significantly associated with the persistent symptoms variable (OR = 4.57, p = 0.045, 95% CI = 1.07–22.41) and the PPS (OR = 0.93, p = 0.001, 95% CI = 0.88–0.96). Conclusions: Prognostic models such as ours that include variables commonly included in clinical assessments can help nursing home professionals prioritize and ensure adequate mobilization of palliative care resources, which are very limited in these institutions.

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