The prevalence of artificially administered nutrition and hydration in different age groups among patients with advanced cancer admitted to palliative care units

Background: Studies on the appropriate use of urinary catheters for cancer patients at the end of life are limited. Aim: To clarify the differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units. Design: Pre-planned secondary analysis of a multicenter, prospective cohort study; East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED). Setting/participants: This study enrolled consecutive advanced cancer patients admitted to palliative care units between January and December 2017. The final study group comprised 1212 patients from 21 institutions throughout Japan. Results: Out of the 1212 patients, 380 (31.4%; 95% confidence interval, 28.7%–34.0%) underwent urinary catheterization during their palliative care unit stay, and the prevalence of urinary catheterization in patients who died at palliative care units by institution ranged from 0.0% to 55.4%. When the 21 participating institutions were equally divided into three groups according to the institutional prevalence of catheterization, patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation were more likely to be catheterized in institutions with a high prevalence of catheterization than in those with a low or moderate prevalence ( p < 0.008, p = 0.008, and p < 0.008, respectively). Conclusion: This study revealed that the institutional prevalence of urinary catheterization in advanced cancer patients at palliative care units widely varied. Further studies are needed to establish the appropriate use of urinary catheters, especially in patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation.

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Is spiritual well-being related to survival time of inpatients with advanced cancer? An East Asian cohort study

10.21203/rs.3.rs-269752/v1 ◽

2021 ◽

Author(s):

Yusuke Hiratsuka ◽

Sang-Yeon Suh ◽

Seon Hye Won ◽

Sung Eun Choi ◽

Sun Hyun Kim ◽

...

Keyword(s):

Palliative Care ◽

Cohort Study ◽

Survival Time ◽

Advanced Cancer ◽

East Asian ◽

Well Being ◽

Cox Proportional Hazards Model ◽

Spiritual Well Being ◽

Palliative Care Units ◽

The Relationship

Abstract Purpose: It has been suggested that psychosocial factors are related to survival time in patients with cancer. However, there is no cross-cultural study examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries. Methods: This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea and Taiwan. SWB was measured at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors. Results: A total of 2638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5 to 19.5) in Japan, 23.0 days (95% CI 19.9 to 26.1) in Korea and 15.0 days (95% CI 13.0 to 17.0) in Taiwan. Four variables were significant in Japan, Korea and Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01 to 1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00 to 1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77 to 1.35; p = 0.89). Conclusion: SWB of patients with advanced cancer was related to survival time in Taiwan but not in Japan or Korea. The findings suggest that spiritual care may contribute to prolonged survival in patients with far advanced cancer.

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Need for nutritional support in advanced cancer patients with cachexia: A survey in palliative care settings.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.31_suppl.100 ◽

2017 ◽

Vol 35 (31_suppl) ◽

pp. 100-100

Author(s):

Koji Amano ◽

Tatsuya Morita ◽

Jiro Miyamoto ◽

Teruaki Uno ◽

Hirofumi Katayama ◽

...

Keyword(s):

Palliative Care ◽

Parenteral Nutrition ◽

Cancer Patients ◽

Advanced Cancer ◽

Nutritional Support ◽

Cancer Cachexia ◽

Tube Feeding ◽

Advanced Cancer Patients ◽

Nutrition And Hydration ◽

To Receive

100 Background: Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings.The aim of this survey is to examine the relationship between the need for nutritional support and cancer cachexia, specific needs, perceptions, and beliefs. Methods: We conducted a questionnaire in outpatient service/palliative care teams/palliative care units. Patients were classified into two groups: 1) Non-cachexia/Pre-cachexia and 2) Cachexia/Refractory cachexia. Results: A total of 117 out of 121 patients responded (96.7%). A significant difference was observed in the need for nutritional support between the groups: Non-cachexia/Pre-cachexia (32.7%) and Cachexia/Refractory cachexia (53.6%) (p = 0.031). The specific needs of patients requiring nutritional support were nutritional counseling (93.8%), ideas to improve food intake (87.5%), oral nutritional supplements (83.0%), parenteral nutrition and hydration (77.1%), and tube feeding (22.9%). The top perceptions regarding the best time to receive nutritional support and the best medical staff to provide nutritional support were “when anorexia, weight loss, and muscle weakness become apparent” (48.6%) and “nutritional support team” (67.3%), respectively. The top three beliefs of nutritional treatments were “I do not wish to receive tube feeding” (78.6%), “parenteral nutrition and hydration are essential” (60.7%), and “parenteral hydration is essential” (59.6%). Conclusions: Patients with cancer cachexia had a greater need for nutritional support. Advanced cancer patients wished to receive nutritional support from medical staff with specific knowledge when they become unable to take sufficient nourishment orally and the negative impact of cachexia becomes apparent. Additionally, most patients wished to receive parenteral nutrition and hydration.

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Acute symptomatic complications among patients with advanced cancer admitted to acute palliative care units: A prospective observational study

Palliative Medicine ◽

10.1177/0269216315583031 ◽

2015 ◽

Vol 29 (9) ◽

pp. 826-833 ◽

Cited By ~ 20

Author(s):

David Hui ◽

Renata dos Santos ◽

Suresh Reddy ◽

Maria Salete de Angelis Nascimento ◽

Donna S Zhukovsky ◽

...

Keyword(s):

Palliative Care ◽

Observational Study ◽

Advanced Cancer ◽

Prospective Observational Study ◽

Palliative Care Units

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Thromboprophylaxis for inpatients with advanced cancer in palliative care settings: A systematic review and narrative synthesis

Palliative Medicine ◽

10.1177/0269216319830860 ◽

2019 ◽

Vol 33 (5) ◽

pp. 486-499 ◽

Cited By ~ 2

Author(s):

Runting Cai ◽

Camilla Zimmermann ◽

Monika Krzyzanowska ◽

John Granton ◽

Breffni Hannon

Keyword(s):

Systematic Review ◽

Palliative Care ◽

Venous Thromboembolism ◽

Advanced Cancer ◽

Meta Analysis ◽

Grey Literature ◽

Assessment Tools ◽

Cochrane Library ◽

Palliative Care Units ◽

The Cochrane Library

Background: Patients with advanced cancer have an elevated risk of venous thromboembolism. Increasingly, patients are admitted to palliative care settings for brief admissions, with greater numbers of discharges (vs deaths) reported internationally. There is limited guidance around the use of thromboprophylaxis or incidence of venous thromboembolism for these patients. Aim: The aim of this study was to review the use of thromboprophylaxis as well as incidence of venous thromboembolism and bleeding in palliative care units or residential hospices for patients with advanced cancer. Design: A systematic review using Cochrane methods. Data sources: Medline, Embase and the Cochrane Library were searched up to 28 September 2018 along with a grey literature search; the reference lists of selected papers were hand-searched. Inclusion criteria were original papers assessing thromboprophylaxis use in palliative care units or residential hospices for adult inpatients with cancer. Two reviewers independently selected and appraised papers using a tool designed for disparate data. Heterogeneity in study design made a meta-analysis not possible. Results: A total of 11 full-text papers (9 quantitative and 2 qualitative) and 11 abstracts were included. Thromboprophylaxis use ranged between 4% and 53%; venous thromboembolism rates between 0.5% and 20%; and bleeding incidence was between 0.01% and 9.8%. Risk assessment tools were used infrequently and adherence to international thromboprophylaxis guidelines ranged between 5% and 71%. Physician opinions differed around the use of thromboprophylaxis; patients were largely accepting of thromboprophylaxis if it was offered. Conclusion: There is limited evidence around the optimal use of thromboprophylaxis for patients with advanced cancer admitted to palliative care settings. Although some patients may derive benefit, further research in this area is warranted.

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