Utility of Palliative Prognostic Index in Predicting Survival Outcomes in Patients With Hematological Malignancies in the Acute Ward Setting. (May 2022)

• Record Type: Journal Article
• Authors: Lee, Shu-Hui; Chou, Wen-Chi; Yang, Hsin-Yi; Chen, Chia-Chia; Chang, Hung; Wang, Po-Nan; Kuo, Ming-Chung; Kao, Yu-Feng; Ho, Lun-Hui; Hsueh, Shun-Wen; Kao, Chen-Yi; Hsueh, William Harrison; Hung, Chia-Yen; Hung, Yu-Shin
• Is Part Of: American journal of hospice & palliative care. Volume 39:Number 5(2022)
• Page Start: 548
• Page End: 554
• Publication Date: 2022-05
• Subjects: palliative prognostic index -- in-hospital mortality -- survival -- leukemia -- lymphoma; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/10499091211028820
• Languages: English
• ISSNs: 1049-9091

Abstract

Background: The palliative prognostic index (PPI) predicts the life expectancy of patients with terminally ill cancer in hospice settings. This study aimed to evaluate PPI as a prognostic tool for predicting the life expectancy of patients with hematological malignancies admitted to the acute ward. Methods: A total of 308 patients with hematological malignancies admitted to the hematological ward at a medical center between January 2016 and December 2017 were consecutively enrolled. PPI was scored within 24 h of admission. All patients were categorized into 3 groups by PPI for comparing survival and in-hospital mortality rates. Results: The median survival times were 38.4, 3.6, and 1.1 months for patients with good, intermediate, and poor prognostic group, respectively. The hazard ratio was 2.31 (95% CI 1.59-3.35, p < 0.001) when comparing the intermediate and good prognosis groups, and 3.90 (95% CI 2.52-6.03, p < 0.001) when comparing the poor and good prognosis groups. Forty-five (14.6%) patients died at discharge; in-hospital mortality rates among the good, intermediate, and poor prognostic groups were 9.0%, 23.4%, and 46.4%, respectively. The adjusted odds ratio for in-hospital mortality was 1.96 (95% CI, 0.80-4.82, p = 0.14) and 5.25 (95% CI, 2.01-13.7, p < 0.001) for patients in the intermediate and poor prognostic groups compared to those in the good prognostic group. Conclusion: PPI is an accurate prognostic tool for predicting survival times and in-hospital mortality rates in patients with hematological malignancies in an acute ward setting. PPI could assist clinicians in discussing end-of-life issues and in referring patients with hematological malignancies to palliative care.