Prospective clarification of the utility of the palliative prognostic index for patients with advanced cancer in the home care setting

Jun Hamano; Yoshiyuki Kizawa; Takami Maeno; Hiroka Nagaoka; Yasuo Shima; Tetsuhiro Maeno

doi:10.1177/1049909113504982

Prospective clarification of the utility of the palliative prognostic index for patients with advanced cancer in the home care setting

Am J Hosp Palliat Care. 2014 Dec;31(8):820-4. doi: 10.1177/1049909113504982. Epub 2013 Sep 16.

Authors

Jun Hamano¹, Yoshiyuki Kizawa², Takami Maeno³, Hiroka Nagaoka⁴, Yasuo Shima⁵, Tetsuhiro Maeno³

Affiliations

¹ Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan junhamano@md.tsukuba.ac.jp.
² Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
⁴ Department of General Medicine and Primary Care, University of Tsukuba Hospital, Tsukuba, Japan.
⁵ Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan.

PMID: 24043883
DOI: 10.1177/1049909113504982

Abstract

Aims: This study aimed to prospectively clarify the accuracy of the Palliative Prognostic Index (PPI) for advanced cancer patients in home care settings.

Method: The study included 66 advanced cancer patients who received home visiting services between April 2010 and June 2012, and who died at home or in the hospital. Using medical records from initial home visits, we prospectively calculated PPI scores along with sensitivity and specificity.

Results: For 3- and 6-week survival, prognostic prediction showed respective sensitivities of 60% and 70.6%, and specificities of 87.0% and 71.9%.

Conclusion: The sensitivity of the PPI for advanced cancer patients in home care settings was lower than that reported for patients in palliative care units. Development of prognostic tools suitable for home care settings is needed.

Keywords: home care setting; palliative care; palliative prognostic index; patients with advanced cancer; prognostic prediction; prospective study.

MeSH terms

Adult
Aged
Aged, 80 and over
Female
Home Care Services*
Humans
Male
Middle Aged
Neoplasms / diagnosis*
Palliative Care / methods*
Prognosis
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index