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Clinical calculator summary

Palliative Prognostic Index

A bedside palliative prognostic index using performance, intake, edema, dyspnea, and delirium without blood tests.

Evidence-based context for fast calculator use

Purpose:
Support short-term survival assessment and care planning in advanced illness
Population:
Patients with advanced cancer in palliative-care settings
Factors:
Palliative Performance Scale, Oral intake, Edema, Dyspnea at rest, Delirium
Reference:
Morita et al., Support Care Cancer. 1999
HomePalliative Prognostic Index (PPI)
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Palliative Prognostic Index (PPI)

Clinical Context & Background

The Palliative Prognostic Index (PPI) is a scoring system used to predict survival in terminally ill cancer patients. It is based on the Palliative Performance Scale (PPS), oral intake, edema, dyspnea at rest, and delirium. It does not require blood tests.
Primary Source EvidenceMorita T, Tsunoda J, Inoue S, Chihara S. The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients. Support Care Cancer. 1999;7(3):128-133.
Formula Logic
Sum of weighted clinical symptoms.

Reference Data

PPI ScoreSurvival Prediction
≤ 4Survival likely > 6 weeks
> 6Survival likely < 3 weeks

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use when rapid bedside prognostic support is needed and current PPS, intake, edema, dyspnea, and delirium are documented.
  • Use only when the patient and clinical setting match the population described for Palliative Prognostic Index.

How To Interpret

  • Higher scores are associated with shorter survival, but reversible delirium or symptoms can change the estimate.
  • Interpret thresholds with the entered units, current clinical status, and local guideline context.

What To Do Next

  • Review reversible contributors, repeat after major clinical change, and use the result for goals and anticipatory-care discussion.
  • Document the inputs, result, clinical judgment, and any reason for deviating from the model-guided pathway.

Limitations

  • Do not treat a single PPI result as an exact survival prediction or a substitute for longitudinal clinical judgment.
  • This calculator supports clinical assessment and does not independently prescribe treatment.

Validated Population

Patients with advanced cancer in palliative-care settings

Clinical example

A rising PPI driven by declining PPS, intake, and delirium supports urgent care planning while reversible causes are still assessed.

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Frequently Asked Questions

What is Palliative Prognostic Index used for?

Support short-term survival assessment and care planning in advanced illness. It is intended for patients with advanced cancer in palliative-care settings.

Does Palliative Prognostic Index determine treatment by itself?

No. Confirm the population, inputs, contraindications, competing risks, and current guideline recommendations before acting on the result.

Evidence-based oncology decision support. Verify with clinical guidelines.