Opi
Calc
BODE Index (Palliative context)
CAM-S (Confusion Assessment Method - Severity)
CPOT (Critical-Care Pain Observation Tool)
Death Rattle Scoring (Victoria)
Distress Thermometer
Edmonton Symptom Assessment System (ESAS-r)
FAST Scale (Dementia)
IPOS (Integrated Palliative Outcome Scale)
Memorial Symptom Assessment Scale (MSAS)
Menten Score
Morphine Equivalent Daily Dose (MEDD)
Nursing Delirium Screening Scale (Nu-DESC)
Opioid Risk Tool (ORT)
PAINAD Scale
Palliative Performance Scale (PPSv2)
Palliative Prognostic (PaP) Score
Palliative Prognostic Index (PPI)
Respiratory Distress Observation Scale (RDOS)
Richmond Agitation-Sedation Scale (RASS-PAL)
Seattle Heart Failure Model (SHFM)
e-PaP Score
Palliative Prognostic (PaP) Score
Palliative PaP Score: Integrates clinical gestalt with objective parameters for 30-day mortality prediction.
Karnofsky Performance Status
10% - Mostly in bed
20% - Mostly in bed, some care
40% - Unable to work
50% - Unable to work, self-care possible
60% - Occasionally unable to work
70% - Unable to work, can care for self
80% - Normal activity with effort
90% - Normal activity with minor symptoms
Clinician's Estimate of Survival
Good (≥3 months) - 0 pts
Moderate (≤3 months estimate) - 2 pts
Poor (<1 month estimate) - 4 pts
Anorexia Present?
No (2 pts if yes)
Yes
Dyspnea Present?
No (3 pts if yes)
Yes
WBC Count (×10⁹/L)
Lymphocyte Percentage (%)
Calculate PaP Score
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Prediction of 30-day mortality in advanced cancer patients
Integration of clinical judgment with objective laboratory parameters
Advanced care planning discussions in oncology palliative settings
Guiding symptom management intensity based on prognosis
Section 2
Formula & Logic
Scoring Components
Clinical gestalt assessment
Presence of anorexia
Presence of dyspnea at rest
White blood cell (WBC) count
Lymphocyte percentage
Interpretation
Low risk score
30-day mortality risk < 30%
Intermediate risk
30-day mortality risk 30–70%
High risk score
30-day mortality risk > 70%
Section 3
Pearls/Pitfalls
Key Advantages
Validated in large prospective cancer cohort
Combines subjective and objective data
Specific for 30-day mortality prediction
Known Limitations
Requires clinical gestalt assessment; some subjectivity
Originally derived in cancer populations; generalizability uncertain
Last Comprehensive Review: 2026
Related Palliative Care Tools
Palliative Performance Scale
Palliative Prognostic Index
e-PaP Score
Menten Score
Edmonton Symptom Assessment System
IPOS
Distress Thermometer
Memorial Symptom Assessment Scale
Morphine Equivalent Daily Dose
Opioid Risk Tool
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