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Fast Fact and Concept #125:
The Palliative Performance Scale (PPS) |
| L. Scott Wilner, MD and Robert Arnold, MD
The Palliative Performance Scale (PPS) uses five
observer-rated domains correlated to the Karnofsky Performance Scale
(100-0). The PPS is a reliable and valid tool and correlates well with
actual survival and median survival time for cancer patients. It has been
found useful for purposes of identifying and tracking potential care needs
of palliative care patients, particularly as these needs change with
disease progression. Large validation studies are still needed, as is
analysis of how the PPS does, or does not, correlate with other available
prognostic tools and commonly used symptom scales.
| PALLIATIVE
PERFORMANCE SCALE (PPS) |
|
% |
Ambulation |
Activity Level
Evidence of Disease
|
Self-Care |
Intake |
Level of Consciousness
|
Estimated Median Survival
in Days
(a) (b) (c) |
|
100 |
Full |
Normal
No Disease |
Full |
Normal |
Full |
N/A |
N/A
|
108 |
|
90 |
Full |
Normal
Some Disease |
Full |
Normal |
Full |
|
80 |
Full |
Normal with Effort
Some Disease |
Full |
Normal or Reduced |
Full |
|
70 |
Reduced |
Can’t do normal job
or work
Some Disease |
Full |
as above |
Full |
145 |
|
60 |
Reduced |
Can’t do hobbies or housework
Significant Disease |
Occasional Assistance
Needed |
as above |
Full or Confusion |
29 |
4 |
|
50 |
Mainly sit/lie |
Can’t do any work
Extensive Disease |
Considerable Assistance
Needed |
as above |
Full or Confusion |
30 |
11 |
41 |
|
40 |
Mainly
in Bed |
as above |
Mainly Assistance |
as above |
Full or Drowsy or Confusion |
18 |
8 |
|
30 |
Bed Bound |
as above |
Total Care |
Reduced |
as above |
8 |
5 |
|
20 |
Bed Bound |
as above |
as above |
Minimal |
as above |
4 |
2 |
6 |
|
10 |
Bed Bound |
as above |
as above |
Mouth Care Only |
Drowsy or coma |
1 |
1 |
|
0 |
Death |
- |
- |
- |
-- |
|
|
|
(a) See Virik and Glare, reference below. Survival post
admission to inpatient palliative unit.
(b) See Anderson, reference below. Days until inpatient death following
admission to an acute hospice unit, diagnoses not specified.
(c) See Morita, reference below. Survival post admission to inpatient
palliative unit, cancer patients only.
REFERENCES:
 | Anderson F, Downing GM, Hill J. Palliative Performance Scale (PPS):
A New Tool. Journal of Palliative Care. 1996; 12(1); 5-11. |
| Morita T, Tsunoda J, Inoue S, et al. Validity of the Palliative
Performance Scale from a Survival Perspective. J Pain Symp Manage. July,
1999; 18(1): 2-3. |
| Virik K, Glare P. Validation of the Palliative Performance Scale for
Inpatients Admitted to a Palliative Care Unit in Sydney, Australia. J
Pain Symp Manage. June, 2002; 23(6): 455-7. |
Copyright/Referencing Information : Users are free to
download and distribute Fast Facts for educational purposes only. Citation
for referencing: Wilner FS and Arnold R. The Palliative Performance Scale.
Fast Facts and Concepts #125, November 2004 . End-of-Life Palliative
Education Resource Center
www.eperc.mcw.edu.
Disclaimer: Fast Facts provide educational
information, this information is not medical advice. Health care providers
should exercise their own independent clinical judgment. Some Fast Fact
information cites the use of a product in dosage, for an indication, or in
a manner other than that recommended in the product labeling. Accordingly,
the official prescribing information should be consulted before any such
product is use
Creation Date: 10/2004
Format: Handouts
Purpose: Instructional Aid, Self-Study Guide, Teaching
Audience(s)
| |
Training: Fellows, PGY1 (Interns), PGY2-6,
Physicians in Practice |
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Specialty: Anesthesiology, Emergency Medicine,
Family Medicine, General Internal Medicine, Geriatrics,
Hematology/Oncology, Neurology, OB/GYN, Ophthalmology,
Pulmonary/Critical Care, Pediatrics, Psychiatry, Surgery |
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Non-Physician: Nurses |
ACGME Competencies: Patient Care, Medical Knowledge
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