Comparison of Prognostic Abilities of Palliative Prognostic Index, Laboratory Prognostic Score, and Palliative Prognostic Score

Abstract

ContextFew studies have compared the prognostic value of scoring systems based on physical and blood parameters in terminally ill patients with cancer. ObjectivesThis study evaluated the prognostic abilities of Palliative Prognostic Index (PPI), Laboratory Prognostic Score (LPS), and Palliative Prognostic Score (PaP). MethodsWe included 989 terminally ill patients with cancer who consulted for admission to our palliative care unit. We compared the discriminative abilities of PPI, LPS, and PaP for 7-, 14-, 30-, 60-, and 90-day mortality. Additionally, we compared the estimated median survival of PPI, LPS, and PaP with the actual survival (AS). The prediction accuracy was considered adequate if the ratio of estimated median survival in days to AS in days fell within the range of 0.66 to 1.33, optimistic when it exceeds 1.33, and pessimistic when it falls below 0.66. ResultsThe accuracies for 7-, 14-, 30-, 60-, and 90-day mortality were superior for PPI, LPS, LPS, PaP, and PaP (72%, 73%, 71%, 80%, and 82%), respectively, although the discriminative abilities for 7-, 14-, 30-, 60-, and 90-day mortality were similar among the three scoring systems. The prediction accuracy of survival (PAS) was similar among the three scoring systems with adequate, optimistic, and pessimistic rates of 36-41%, 20-46%, and 16-38%, respectively. PAS was superior in actual survival for 14-59 days. ConclusionsThe prognostic abilities of PPI, LPS, and PaP were comparable. The most adequate estimation occurred for patients with AS for 14-59 days. A more accurate prognostic model is needed for patients with longer survival.