title: The effect of underlying health status on patient or surrogate preferences for end-of-life care: a pilot study.
abstract: This study explored the role of health status, as measured by the Palliative Performance Score, in shaping patient preferences for end-of-life care. Scores were correlated with 3 potential goals of care: prolonging life, maintaining function, and maximizing comfort among patients seen in palliative care consultation. Eighty-six patients expressed treatment preferences: 16 (19%) preferred prolonging life, 23 (27%) preferred maintaining function, and 47 (54%) preferred maximizing comfort (P < .0001); their average scores +/- standard deviation were, respectively, 51.9 +/- 19.4, 56.5 +/- 16.7, and 45.3 +/- 14.1 (P = .0459). There was a significant relationship between patient preferences and Palliative Performance Score, with lower scores indicating preferences for comfort and higher scores indicating a preference for maintaining function and life expectancy. Further research is needed to test the sensitivity of health status, as measured by the Palliative Performance Score, in affecting patient preferences.
authors.affiliation: Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA.
authors.forename: Kara Zivin
authors.initials: KZ
authors.lastname: Bambauer
authors.forename: Muriel R
authors.initials: MR
authors.lastname: Gillick
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010166:Palliative Care; D010358:Patient Participation; D017060:Patient Satisfaction; D010865:Pilot Projects; D012720:Severity of Illness Index; D013727:Terminal Care