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palliative

Palliative Prognostic Index (PPI)

Predicts survival in advanced cancer patients (Morita 1999). Sums 5 weighted clinical variables. PPI >6 predicts <3 weeks survival; >4 predicts <6 weeks (sensitivity ~80%, specificity ~85%).

Score interpretation

PPI ≤4 — survival likely >6 weeks 0–4

→ Continue current palliative plan. Reassess if clinical change. Discuss preferred place of care.

PPI 4.1–6 — survival likely 3–6 weeks 4.1–6

→ Activate end-of-life pathway: ReSPECT / advance care plan complete; anticipatory medications prescribed; family meeting; consider hospice referral.

PPI >6 — survival likely <3 weeks 6.1–15

→ Last-days-of-life care: stop non-essential medications, anticipatory subcutaneous PRN (morphine, midazolam, glycopyrronium, levomepromazine); spiritual / family support; bereavement planning.

Interpretation bands for the PPI. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.