Independent prospective validation of the PaP score in terminally ill patients referred to a hospital-based palliative medicine consultation service

The aim of this prospective study was to validate the Palliative Prognostic (PaP) Score in a population of hospitalized patients in Australia in order to determine its applicability in a different setting to that in which it was originally developed. Individual PaP scores were calculated for 100 ter minally-ill patients consecutively referred to a palliative medicine consul tation service based in a university teaching hospital. The PaP score was a ble to subdivide this heterogeneous patient population into three groups, t he differences being highly statistically significant. Median survivals for the three groups were, respectively, 60 days (95% confidence interval 41-8 9 days), 34 days (25-40), and 8 days (2-11). The percentage survival at 30 days for the three groups was 66%, 54%, and 5% respectively. These data sug gest that the PaP scoring system is a reasonably robust method for prognost ication in advanced cancer that appears to be independent of the setting. T he short survival of the third group in this study, which is consistent wit h the presence of a subset of gravely ill patients within the hospital sett ing who are referred to specialist palliative care services very late in th e course of their illness, raises important issues for the care and treatme nt of these individuals. J Pain Symptom Manage 2001;22:891-898 (C) U.S. Can cer Pain Relief Committee, 2001.