• Jun Hamano, Tatsuya Morita, Taketoshi Ozawa, Hideki Shishido, Masanori Kawahara, Shigeru Aoki, Akira Demizu, Masahiro Goshima, Keiji Goto, Yasuaki Gyoda, Kotaro Hashimoto, Sen Otomo, Masako Sekimoto, Takemi Shibata, Yuka Sugimoto, Mikako Matsunaga, Yukihiko Takeda, Jun Nagayama, and Hiroya Kinoshita.
• Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
• J Pain Symptom Manage. 2015 Oct 1; 50 (4): 542-7.e4.

ContextAlthough the Palliative Prognostic Index (PPI) is a reliable and validated tool to predict the survival of terminally ill cancer patients, all clinicians cannot always precisely diagnose delirium.ObjectivesThe primary aim of this study was to examine the predictive value of a simplified PPI. In the simplified PPI, a single item from the Communication Capacity Scale was substituted for the delirium item of the original.MethodsThis multicenter prospective cohort study was conducted in Japan from September 2012 through April 2014 and involved 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services. Palliative care physicians recorded clinical variables at the first assessment and followed up patients six months later.ResultsA total of 2425 subjects were recruited; 2343 had analyzable data. The C-statistics of the original and simplified PPIs were 0.801 and 0.800 for three week and 0.800 and 0.781 for six-week survival predictions, respectively. The sensitivity and specificity for survival predictions using the simplified PPI were 72.9% and 67.6% (for three week) and 80.3% and 61.8% (for six week), respectively.ConclusionThe simplified PPI showed essentially the same predictive value as the original PPI and is an alternative when clinicians have difficulties in diagnosing delirium.Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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