Risk factors of sudden unexpected death in patients with advanced cancer near the end of life

2021 ◽  
pp. 1-5
Author(s):  
Tomohiko Taniyama ◽  
Rie Tokutani ◽  
Shuji Hiramoto
Keyword(s):  
Risk Factors ◽  
End Of Life ◽  
Advanced Cancer ◽  
Group Performance ◽  
Eastern Cooperative Oncology Group ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Number Of Patients ◽  
Independent Risk Factors ◽  
Cardiac Comorbidity

Abstract Background The definition of sudden unexpected death (SUD) in patients with advanced cancer near the end of life (EOL) was unclear. Methods This study was conducted as a single-center retrospective analysis. We analyzed 1,282 patients who died of advanced cancer from August 2011 to August 2019 retrospectively. We divided into patients who died within 24 h after the acute change of general condition or others and analyzed risk factors by a multiple logistics method. The reason for SUD was found, the reason is detected by using an electronic medical record retrospectively. The risk factors in SUD were analyzed using age, sex, EOL symptom and treatment, the primary site of cancer, metastatic site of cancer, comorbidly, chemotherapy, and Eastern Cooperative Oncology Group Performance Status. The primary endpoint was to identify the frequency and risk factors of SUD in patients with advanced cancer near the EOL. Results As a background, the median age is 73 years old, 690 males, 592 females, 227 gastroesophageal cancers, 250 biliary pancreatic cancers, 54 hepatocellular carcinomas, 189 colorectal cancer, 251 lung cancers, 71 breast cancers, 58 urological malignancies, 60 gynecological malignancies, 47 head and neck cancer, 31 hematological malignancies, and 22 sarcomas. The number of patients who died suddenly was 93 (7.2%) at EOL. In a multivariate analysis, Age (ORs 0.619), sex (ORs 1.700), patients with EOL delirium (ORs 0.483), nausea and vomiting (ORs 2.263), 1L or more infusion (ORs 3.479), EOL opioids (ORs 0.465), EOL sedations (ORs 0.339), and with cardiac comorbidity (ORs 0.345) were independent risk factors. Conclusions The frequency of patients who died suddenly was 7.2% (n = 93) at EOL. Age, sex, EOL symptom, EOL treatment, and cardiac comorbidity were independent risk factors in patients with advanced cancer near the EOL. Information on these risk factors is useful to explaining their EOL in advance.

The frequency and predictors of end-of-life symptom in patients with advanced cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24061-e24061
Author(s):  
Shuji Hiramoto ◽  
Ayako Kikuchi ◽  
Tomohiko Taniyama ◽  
Hori Tetsuo ◽  
Akira Yoshioka ◽  
...  
Keyword(s):  
Cancer Pain ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Peritoneal Metastasis ◽  
Group Performance ◽  
Nausea And Vomiting ◽  
Advanced Cancer Patients ◽  
Consciousness Level ◽  
Number Of Patients

e24061 Background: Advanced cancer patients complain of highly distressing symptom at the end-of-life, and important reasons for palliative intervention to relive symptoms. Methods: We analyzed 1282 patients who died of advanced cancer from August 2011 to August 2019 retrospectively. We divided into patients who complain of symptom include fatigue, dyspnea, nausea and vomiting, and cancer pain, or didn’t for 3 days prior to death, and analyzed predictors by multiple logistics method. The primary endpoint of this study was to identify frequency and predictors of end-of-life symptoms in advanced cancer patients. Results: As a background, the median age is 73 years old, 690 males, 592 females, 227 gastroesophageal cancers, 250 biliary pancreatic cancers, 54 hepatocellular carcinomas, 189 colorectal cancer, 251 lung cancers, 71 breast cancers, 58 urological malignancies, 60 gynecological malignancies, 47 head and neck cancer, 31 hematological malignancies, and 22 sarcomas. Number of patients who complained of dyspnea, fatigue, nausea and vomiting, and cancer pain were 235 (18.3%), 318 (24.8%), 81 (6.3%), and 322 (25.1%) at the end-of-life. In a multivariate analysis, peritoneal metastasis (ORs 1.812), with mental (ORs 0.549), palliative referral (ORs 0.680), Eastern Cancer Organization Group Performance Status (ECOG-PS) (OR0.679) and consciousness level (ORs 0.610) was independent predictors in patients with fatigue at the end-of-life. Chest cancer (Odds Ratio 2.635), lung (ORs 2.159), brain (ORs 0.431) and peritoneal metastasis (ORs 0.602), with mental (ORs 0.429), respiratory (ORs 1.960) and metabolic disorder (ORs 0.520), palliative referral (ORs 0.645) and consciousness level (ORs 0.468) was independent predictors in patients with dyspnea. Lung metastasis (ORs 0.480, peritoneal metastasis (ORs 1.812), with anti-cancer therapy (OR 2.244) and consciousness level (ORs 0.610) was independent predictors in patients with nausea and vomiting. Brain metastasis (ORs 0.435, liver metastasis (ORs 1.374), and consciousness level (ORs 0.599) was independent predictors in patients with cancer pain. Conclusions: We reported frequency and independent predictors of end-of-life symptoms in advanced cancer patients. Information on these predictors be useful to explaining about their end-of-life in advance.

Sudden unexpected death in epilepsy: A search for risk factors

2007 ◽  
Vol 10 (1) ◽  
pp. 138-141 ◽  
Author(s):  
Nikolas Hitiris ◽  
Suraya Suratman ◽  
Kevin Kelly ◽  
Linda J. Stephen ◽  
Graeme J. Sills ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sudden Unexpected Death ◽  
Unexpected Death

scholarly journals Practice Guideline Summary: Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society

2017 ◽  
Vol 17 (3) ◽  
pp. 180-187 ◽  
Author(s):  
Cynthia Harden ◽  
Torbjörn Tomson ◽  
David Gloss ◽  
Jeffrey Buchhalter ◽  
J. Helen Cross ◽  
...  
Keyword(s):  
Risk Factors ◽  
Guideline Development ◽  
Evaluation Process ◽  
Incidence Rates ◽  
Sudden Unexpected Death ◽  
Dissemination And Implementation ◽  
Seizure Freedom ◽  
High Confidence ◽  
Unexpected Death ◽  
Assessment Development

Objective: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. Methods: Systematic review of evidence; modified Grading Recommendations Assessment, Development and Evaluation process for developing conclusions; recommendations developed by consensus. Results: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0–17 years) is 0.22/1,000 patient-years (95% CI 0.16–0.31) (high confidence in evidence). SUDEP risk increases in adults to 1.2/1,000 patient-years (95% CI 0.64–2.32) (low confidence in evidence). The major risk factor for SUDEP is the occurrence of generalized tonic-clonic seizures (GTCS); the SUDEP risk increases in association with increasing frequency of GTCS occurrence (high confidence in evidence). Recommendations: Level B: Clinicians caring for young children with epilepsy should inform parents/guardians that in 1 year, SUDEP typically affects 1 in 4,500 children; therefore, 4,499 of 4,500 children will not be affected. Clinicians should inform adult patients with epilepsy that SUDEP typically affects 1 in 1,000 adults with epilepsy per year; therefore, annually 999 of 1,000 adults will not be affected. For persons with epilepsy who continue to experience GTCS, clinicians should continue to actively manage epilepsy therapies to reduce seizures and SUDEP risk while incorporating patient preferences and weighing the risks and benefits of any new approach. Clinicians should inform persons with epilepsy that seizure freedom, particularly freedom from GTCS, is strongly associated with decreased SUDEP risk.

Sudden Unexpected Death of Two Infants in Baby Carriers

2021 ◽  
Author(s):  
Dennis Storz ◽  
Christof Dame ◽  
Anke Wendt ◽  
Alexander Gratopp ◽  
Christoph Bührer
Keyword(s):  
Risk Factors ◽  
Infant Development ◽  
Sudden Infant Death ◽  
Developed Countries ◽  
Bottle Feeding ◽  
Sudden Unexpected Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Sleeping Position ◽  
Prone Sleeping Position

Sudden unexpected death in infancy (SUDI), previously termed sudden infant death syndrome (SIDS), is the second leading cause of death in infants beyond the neonatal period in Germany, and a major cause of infant mortality in economically well developed countries (OECD Health Statistics, 2019). The risk of SUDI peaks at the age of 2–4 months and then decreases continuously till the end of the first year. A complex multifactorial cause, rather than a single characteristic factor, may cause SUDI within a critical period of infant development (Guntheroth WG et al., Pediatrics 2002; 110: e64–e64). Risk factors include prematurity, male gender, bottle-feeding, prone sleeping position, overheating, as well as exposure to smoke amongst others (Carpenter RG et al., Lancet 2004; 363: 185–191). Thus, health professionals consistently advise and educate parents about avoidable risk factors of SUDI at routine well-baby examinations. Since the advent of SUDI prevention strategies in the 1980s, the incidence has decreased 10fold, from 1,55/1.000 live births in 1991 to 0,15/1000 in 2015. This number seems to have reached a steady state (Statistisches Bundesamt Germany, 2015).

scholarly journals P.091 Anterior surgical fixation for cervical spine flexion-distraction injuries

2017 ◽  
Vol 44 (S2) ◽  
pp. S36-S37
Author(s):  
AS Jack ◽  
G Choy ◽  
G Hardy St-Pierre ◽  
R Fox ◽  
A Nataraj
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Failure Criteria ◽  
Posterior Fixation ◽  
Cervical Spine Injuries ◽  
Failure Data ◽  
Number Of Patients ◽  
Surgical Fixation ◽  
Independent Risk Factors ◽  
Anterior Posterior

Background: Optimal surgical management for flexion--distraction cervical spine injuries remains controversial with anterior, posterior, and circumferential fixation being accepted. Here, we examined risk factors for clinical and radiographic failure in patients with one segment cervical flexion-distraction injuries having undergone anterior surgical fixation. Methods: A retrospective review of 57 consecutive patients undergoing anterior fixation for cervical flexion-distraction injuries between 2008-2012 was performed. The primary outcome was the number of patients requiring additional surgical stabilization and/or radiographic failure. Data collected inlcuded age, gender, mechanism and level of injury, facet pattern injury, and vertebral endplate fracture. Results: Six patients failed clinically and/or radiographically (11%). Four patients (7%) required additional posterior fixation. Two patients identified met radiographic failure criteria, however had fused radiographically, were stable clinically, and no further treatment was pursued. Progressive kyphosis and translation correlated with need for revision (p<0.05 and p=0.02, respectively). No differences were identified for all other clinical and radiological factors assessed. Conclusions: This study supports the growing body of evidence for anterior fixation alone for flexion-distraction injuries. Findings suggest that measurements including segmental translation and kyphosis may predict radiographic failure and need for further surgical stabilization in some patients. Assessment for independent risk factors for anterior approach failure with a validated predictive scoring model should be considered.

Sudden unexpected death in epilepsy: Evidence-based analysis of incidence and risk factors

2005 ◽  
Vol 65 (1-2) ◽  
pp. 101-115 ◽  
Author(s):  
José F. Téllez-Zenteno ◽  
Lizbeth Hernández Ronquillo ◽  
Samuel Wiebe
Keyword(s):  
Risk Factors ◽  
Sudden Unexpected Death ◽  
Evidence Based ◽  
Unexpected Death

The epidemiology of sudden unexpected death: Risk factors for men and women in the Framingham Heart Study

1984 ◽  
Vol 107 (6) ◽  
pp. 1300-1306 ◽  
Author(s):  
Arthur Schatzkin ◽  
Adrienne Cupples ◽  
Tim Heeren ◽  
Suzette Morelock ◽  
Marc Mucatel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Framingham Heart Study ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Men And Women ◽  
Death Risk ◽  
Heart Study
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