Palliative Prognostic Score (PaP Score)
Validated prognostic tool for estimating 30-day survival probability in advanced cancer patients referred to palliative care. Components: dyspnoea, anorexia, KPS, clinical prediction of survival, total WBC, lymphocyte percentage. Score 0–17.5.
Score interpretation
PaP Group A (0–5.5) — >70% probability of surviving 30 days
→ Focus on comfort and quality of life; optimise symptom management; advance care planning; DNACPR discussion; ensure patient goals of care documented; consider appropriate disease-modifying therapy if aligned with goals; support carers and family
PaP Group B (5.6–11) — 30–70% probability of surviving 30 days
→ Palliative care specialist involvement; focused goals of care discussion; avoid futile interventions; aggressive symptom management; consider preferred place of care/death discussion; anticipatory prescribing; family communication; hospice or home palliative care planning
PaP Group C (>11) — <30% probability of surviving 30 days
→ Urgent palliative care team involvement; transition to comfort-focused care; discontinue non-essential medications; anticipatory medications (diamorphine, midazolam, hyoscine) prescribed and available; preferred place of death discussion; family support and counselling; spiritual/chaplaincy support if desired; Liverpool Care Pathway equivalent or local EOLC pathway; out-of-hours palliative care plan
Interpretation bands for the PaP Score. Apply clinical judgement and local guidance.
References
- Pirovano M et al. A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. J Pain Symptom Manage. 1999;17(4):231–239.
Related
Curated clinical cross-links plus same-class fallbacks.
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Factor IX Concentrate · Coagulation Factor Replacement — Haemophilia B
- Ianalumab (Anti-BAFF — Primary Sjögren's Syndrome) · Anti-BAFF Monoclonal Antibody (B-Cell Survival Factor Inhibitor)
- Dalteparin · Low Molecular Weight Heparin — VTE Treatment / Cancer-Associated Thrombosis
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.