Association between continuous deep sedation and survival time in terminally ill cancer patients

2020 ◽  
Vol 29 (1) ◽  
pp. 525-531
Author(s):  
So-Jung Park ◽  
Hee Kyung Ahn ◽  
Hong Yup Ahn ◽  
Kyu-Tae Han ◽  
In Cheol Hwang
Keyword(s):  
Survival Time ◽  
Cancer Patients ◽  
Deep Sedation ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients ◽  
Continuous Deep Sedation

Effectiveness of multidisciplinary team conference on decision-making surrounding the application of continuous deep sedation for terminally ill cancer patients

2013 ◽  
Vol 13 (2) ◽  
pp. 157-164 ◽  
Author(s):  
Kazuhiko Koike ◽  
Takeshi Terui ◽  
Yuji Takahashi ◽  
Yasuo Hirayama ◽  
Naomi Mizukami ◽  
...  
Keyword(s):  
Decision Making ◽  
Retrospective Analysis ◽  
Cancer Patients ◽  
Multidisciplinary Team ◽  
Deep Sedation ◽  
Conscious Experience ◽  
Terminally Ill ◽  
Care Providers ◽  
Terminally Ill Cancer Patients ◽  
Continuous Deep Sedation

AbstractObjective:Continuous deep sedation (CDS) is a way to reduce conscious experience of symptoms of severe suffering in terminally ill cancer patients. However, there is wide variation in the frequency of its reported. So we conducted a retrospective analysis to assess the prevalence and features of CDS in our palliative care unit (PCU).Methods:We performed a systemic retrospective analysis of the medical and nursing records of all 1581 cancer patients who died at the PCU at Higashi Sapporo Hospital between April 2005 and August 2011. Continuous deep sedation can only be administered safely and appropriately when a multidisciplinary team is involved in the decision-making process. Prior to administration of CDS, a multidisciplinary team conference (MDTC) was held with respect to all the patients considered for CDS by an attending physician. The main outcome measures were the frequency and characteristics of CDS (patient background, all target symptoms, medications used for sedation, duration, family's satisfaction, and distress). We mailed anonymous questionnaires to bereaved families in August 2011.Results:Of 1581 deceased patients, 22 (1.39%) had received CDS. Physical exhaustion 8 (36.4%), dyspnea 7 (31.8%), and pain 5 (22.7%) were the most frequently mentioned indications. Continuous deep sedation had a duration of less than 1 week in 17 (77.3%). Six patients (0.38%) did not meet the appropriate criteria for CDS according to the MDTC and so did not receive it. Although bereaved families were generally comfortable with the practice of CDS, some expressed a high level of emotional distress.Significance of results:Our results indicate that the prevalence of CDS will be decreased when it is carried out solely for appropriate indications. Continuity of teamwork, good coordination, exchange of information, and communication between the various care providers are essential. A lack of any of these may lead to inadequate assessment, information discrepancies, and unrest.

scholarly journals Palliative Performance Status, Heart Rate and Respiratory Rate as Predictive Factors of Survival Time in Terminally Ill Cancer Patients

2006 ◽  
Vol 31 (6) ◽  
pp. 485-492 ◽  
Author(s):  
Cristina de Miguel Sánchez ◽  
Sofía Garrido Elustondo ◽  
Alicia Estirado ◽  
Fernando Vicente Sánchez ◽  
Cristina García de la Rasilla Cooper ◽  
...  
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Survival Time ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Performance Status ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients

Factors Associated with Length of Survival among 1081 Terminally Ill Cancer Patients

1995 ◽  
Vol 11 (3) ◽  
pp. 20-24 ◽  
Author(s):  
Pierre Allard ◽  
Albert Dionne ◽  
Diane Potvin
Keyword(s):  
Palliative Care ◽  
Prognostic Factors ◽  
Survival Time ◽  
Cancer Patients ◽  
Performance Status ◽  
Terminally Ill ◽  
Patient Characteristics ◽  
Cancer Site ◽  
Primary Tumor Site ◽  
Terminally Ill Cancer Patients

To improve their ability to estimate the survival of terminally ill cancer patients, palliative care physicians require accurate information on prognostic factors. The objective of this study was to assess the extent to which variables such as patient characteristics and primary tumor site affect the length of survival of terminally ill cancer patients. The study population consisted of 1081 cancer patients admitted for terminal care to a 15-bed palliative care unit from 1985 to 1991. Univariate Kaplan-Meier survival analysis and multivariate Cox regression analyses were used to examine the relationship between patient characteristics at admission and survival time. The factor most strongly associated with shorter survival was poor performance status; this strong relationship was not altered by taking into account sex and primary cancer site in the multivariate analysis. For patients who were bedridden at admission, the death rate was 5.5 times higher (95% confidence interval (CI) 3.4–9.0) than that for ambulatory patients during the first four days of stay and it was 2.8 times higher (95% CI 2.0–3.9) subsequently (up to 19 days). The other prognostic factors significantly but slightly associated with poorer survival in the univariate analysis were primary lung cancer, male sex, and living with a spouse. These findings indicate that performance status is the main prognostic factor for accurately estimating the survival time of terminally ill cancer patients.

Practices and Attitudes of Japanese Oncologists and Palliative Care Physicians Concerning Terminal Sedation: A Nationwide Survey

2002 ◽  
Vol 20 (3) ◽  
pp. 758-764 ◽  
Author(s):  
Tatsuya Morita ◽  
Tatsuo Akechi ◽  
Yuriko Sugawara ◽  
Satoshi Chihara ◽  
Yosuke Uchitomi
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Psychiatric Treatment ◽  
Deep Sedation ◽  
Terminally Ill ◽  
Palliative Sedation ◽  
Professional Burnout ◽  
Palliative Sedation Therapy ◽  
Continuous Deep Sedation ◽  
Psychologic Distress

PURPOSE: To clarify the frequency of practice of sedation therapy for terminally ill cancer patients and to identify physicians’ attitudes toward sedation. METHODS: Questionnaires were mailed to 1,436 Japanese oncologists and palliative care physicians with a request to report their practice of and attitudes toward palliative sedation therapy. RESULTS: A total of 697 physicians returned questionnaires (response rate, 49.6%). Use of mild, intermittent-deep, or continuous-deep sedation for physical and psychologic distress was reported by 89% and 64%, 70% and 46%, and 66% and 38%, respectively. In vignettes in which physicians were asked whether they would use sedation for a patient with refractory dyspnea or with existential distress, 14% and 15%, respectively, chose continuous-deep sedation as a strong possibility. Those physicians less confident with psychologic care and with higher levels of professional burnout were more likely to choose continuous-deep sedation. In vignettes in which they were asked whether they use sedation for a patient with depression or delirium, 39% and 31%, respectively, considered psychiatric treatment to be a strong possibility, and 42% and 50% regarded continuous-deep sedation as a potential treatment option. Physicians less involved in caring for the terminally ill and less specialized in palliative medicine were significantly less likely to choose psychiatric treatment. CONCLUSION: Sedation is frequently used for severe physical and psychologic distress of cancer patients. Physicians’ clinical experiences with the terminally ill and their levels of professional burnout influence the decisions. Training and education for physicians in regard to end-of-life care and valid clinical guidelines for palliative sedation therapy are necessary.

scholarly journals Uric Acid as a Prognostic Factor for Survival Time: A Prospective Cohort Study of Terminally Ill Cancer Patients

2006 ◽  
Vol 31 (6) ◽  
pp. 493-501 ◽  
Author(s):  
Hyun-Sik Shin ◽  
Hye-Ree Lee ◽  
Duk-Chul Lee ◽  
Jae-Yong Shim ◽  
Kyung-Hee Cho ◽  
...  
Keyword(s):  
Uric Acid ◽  
Cohort Study ◽  
Prognostic Factor ◽  
Survival Time ◽  
Cancer Patients ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients

scholarly journals The Effects of Plasma Endotoxin Level on Survival Time of Terminally Ill Cancer Patients

2014 ◽  
Vol 17 (2) ◽  
pp. 57-65 ◽  
Author(s):  
Jin-Ah Lee ◽  
Ho Min Yoon ◽  
Youn Seon Choi ◽  
Jong Eun Yeon ◽  
June Young Lee
Keyword(s):  
Survival Time ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Endotoxin Level ◽  
Terminally Ill Cancer Patients ◽  
Plasma Endotoxin ◽  
Plasma Endotoxin Level
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