Authors (including presenting author) :
Lai BK (1), Ng L Y(1), Kitten Kong TY(1), Kwong MC (1), Law TL(1)
Affiliation :
(1) Palliative Care (Nursing), Central Nursing Division, Queen Elizabeth Hospital
Introduction :
Accurate prediction of imminent death is crucial for clinical teams, terminally ill patients and their families(3,4). It facilitates the optimization of treatment strategies, enhances the care planning and quality of life during end-of-life (EOL) care. Among various prognostication tools, Palliative Performance Scale (PPS) is one of the major validated and reliable one to predict patient’s mortality(6). This study aims to investigates the prognostic capabilities of PPS and highlighted the critical relationship between PPS scores and survival times for patients share cared by Palliative Care(PC) nurses in QEH.
Objectives :
•To assess the reliability of the PPS as a prognostic tool to facilitate EOL planning among clinical team, patient and family. •To analyze the correlation between PPS scores and mortality of patients •To evaluate the effectiveness of PPS in predicting imminent death within days in acute care hospital settings.
Methodology :
This retrospective study analyzes patients who received shared care from the PC nurses from January 2024 to December 2024. Patients engaged by the PC nurses, with documented PPS scores and who passed away before 31/12/2024, were included.
Result & Outcome :
In this study, 327 patients evaluated by the PC nurses were analyzed. Results indicated that over 60% of patients with a PPS ≤ 20% had a survival time of <7 days. Statistical tests showed a significant link between PPS and survival time in acute care (p<0.001). Aligning with previous studies(2), this relationship was stronger in cancer patients(p=0.002) than in non-cancer patients(p=0.02). A significant correlation (p<0.001) was also found between PPS and survival in patients who did not use mechanical ventilation, whereas the correlation was not significant for those who did (p=0.41). In conclusion, a lower PPS score indicates a higher likelihood of imminent death, making PPS a useful tool for healthcare professionals in predicting death for both cancer and non-cancer patients, especially those not on mechanical ventilation. However, further research is needed to develop reliable prognostic tools for routine use in non-palliative settings to improve EOL care planning. •Patient's documented PPS upon engagement by PC nurses
•Survival length from the time of PC nurses engagement to death
•Evaluate the effectiveness of PPS as a prognostication tool for imminent death in acute care settings
