UNASSIGNED: 100 Background: Historically, functional decline is considered to occur steadily and inexorably in the last months of life, with a relatively steep trajectory compared to non- @entity5 @entity1 (pts). As part of a trial evaluating the safety and clinical impact of discontinuing statin medications for @entity1 in the palliative care setting, we recorded the performance status (PS) in 186 @entity5 @entity1 regularly during their time on study and compared changes among those with differing baseline PS levels and between those with and without @entity5 . METHODS: This was a multi-center, parallel-group, unblinded pragmatic trial. Eligibility included: age > 18; life expectancy between 1 month and 1 year, on a statin for >=  3 months for primary or secondary prevention, recent deterioration in PS and no recent active @entity65 . @entity1 , randomized to either discontinue or continue statins, were followed monthly for up to 1 year. Outcomes included survival, cardiovascular events, and @entity16127 was measured using the Australia-modified Karnofsky Performance Status (AKPS) scale and grouped into 4 categories: AKPS=70, 60; 50 and 0-40. The trajectory of PS decline for each group was modeled using a piecewise-linear function allowing for knots at 4, 8, and 12 weeks and separated out between those @entity1 who died and did not die during their time on study. A mixed model was used allowing for a random intercept for each @entity1 . RESULTS: Among the 186 subjects whose primary diagnosis was @entity5 , 111 died; among 195 without @entity5 , 75 died. Those who did not die maintained a relatively flat trajectory of AKPS across 20 weeks; for those who did die, AKPS scores declined somewhat over 20 weeks but this decline was most remarkable among those with a starting AKPS of 0-40. Compared to noncancer @entity1 who died during the study period, PS levels were higher at baseline and had initially greater rates of decline. CONCLUSIONS: For @entity5 @entity1 , PS declines are less dramatic than previous estimates have suggested except for those with AKPS 0-40, suggesting precipitous declines at the very end of life for those with higher initial AKPS. Compared to noncancer @entity1 , PS decline is slightly steeper among @entity5 pts.

Trajectories of performance status decline in XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'advanced cancer'] @entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'participant', 'Participants'] @entity16127 :: ('5967', 'Gene') :: ['PS. PS'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular disease']
@entity5 :: (MESH:D009369,Disease) :: ['advanced cancer']
