A picture of early death after admission in patients with advanced cancer at the end-of-life.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 80-80
Author(s):  
Shuji Hiramoto ◽  
Ayako Kikuchi ◽  
Hori Tetsuo ◽  
Akira Yoshioka ◽  
Tomoko Tamaki
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Performance Status ◽  
Early Death ◽  
Advanced Cancer Patients ◽  
Metastatic Site ◽  
Consciousness Level ◽  
Continuous Sedation ◽  
And Performance

80 Background: Little is unknown about a picture of early death after admission in terminal phase of advanced cancer patients. Previous studies have reported that approximately 14.3% of patients with cancer enroll in hospice in the last 3days of life. Methods: We retrospectively analyzed data for 510 advanced cancer patients at the end of life between August 2011 and August 2016, and contained deceased 83 (16.3%) patients within 3days after admission in our institute. We divided into deceased patients within 3days and more than 4days after admission. Primary endpoints are to compare each symptom (delirium, cancer pain, dyspnea, nausea and vomiting, fatigue) and intervention (hydration, continuous sedation, opioid) at the end of life. Secondary endpoints are association between prognostic factor and early death (within 3days) after admission. Results: Symptoms about delirium, cancer pain, dyspnea, nausea and vomiting were no significant difference between deceased patients within 3days and more than 4days after admission. Mean hydration at the end of life was more significantly volume of infusion for patients in within 3days (0.34 Litters/day) than in over 4 days (0.20 Litters/day). Continuous sedation was significantly less for patients within 3days (4.82%) than in over 4 days (28.64%). Mean of opioid use was significantly less for patients within 3days (Oral morphine dose 23.54mg/day) than in over 4 days (41.11mg/day). In univariate analysis primary site of cancer was tend to (p = 0.086), and number of metastatic site (p = 0.018) and consciousness level ( < 0.0001) and performance status ( < 0.0001) were significantly associated with early death. In multivariate analysis number of metastatic site (p = 0.057) and consciousness level ( < 0.0001) and performance status (p = 0.0004) were significantly associated with early death. Conclusions: We reports a picture of early death after admission in advanced cancer patients at the end-of-life, and number of metastatic site and consciousness level and performance status might be predictors for short-term prediction model.

Advanced Cancer Patients’ Perceptions of Dignity

2018 ◽  
Vol 33 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Sotiria Kostopoulou ◽  
Efi Parpa ◽  
Eleni Tsilika ◽  
Stylianos Katsaragakis ◽  
Irene Papazoglou ◽  
...  
Keyword(s):  
Body Image ◽  
Psychological Distress ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Performance Status ◽  
Depression Scale ◽  
Physical Symptoms ◽  
Role Identity ◽  
Advanced Cancer Patients ◽  
And Performance

Purpose: The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. Methods: The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory–Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS). Results: Moderate to strong statistically significant correlations were found between the 4 subscales of PDI-Gr (psychological distress, body image and role identity, self-esteem, and social support) with G-HADS, G-SAHD, and PGAC ( P < .005), while physical distress and dependency was moderately correlated with depression. Multifactorial analyses showed that preparatory grief, depression, and age influenced psychological distress, while preparatory grief, depression, and performance status influenced body image and role identity. Conclusions: Preparatory grief, psychological distress, and physical symptoms had significant associations with perceptions of dignity among patients with advanced cancer. Clinicians should assess and attend to dignity-distressing factors in the care of patients with advanced cancer.

scholarly journals A Retrospective Analysis of Early Death after Admission in Advanced Cancer Patients at the End-of-life in Single-institution

2017 ◽  
Vol 12 (4) ◽  
pp. 747-752 ◽  
Author(s):  
Tetsuo Hori ◽  
Shuji Hiramoto ◽  
Ayako Kikuchi ◽  
Akira Yoshioka ◽  
Tomoko Tamaki
Keyword(s):  
End Of Life ◽  
Retrospective Analysis ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Early Death ◽  
Advanced Cancer Patients ◽  
Single Institution

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.

scholarly journals Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center

2021 ◽  
pp. 104990912098696
Author(s):  
Livia Costa de Oliveira ◽  
Karla Santos da Costa Rosa ◽  
Ana Luísa Durante ◽  
Luciana de Oliveira Ramadas Rodrigues ◽  
Daianny Arrais de Oliveira da Cunha ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Tumor Type ◽  
Advanced Cancer Patients ◽  
Factors Associated ◽  
Reactive Protein

Background: Advanced cancer patients are part of a group likely to be more susceptible to COVID-19. Aims: To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases. Design: Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI). Results: One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome. Conclusion: Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.

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