6533b7dbfe1ef96bd1270093
RESEARCH PRODUCT
Palliative sedation in advanced cancer patients followed at home: A retrospective analysis
Sebastiano MercadanteGiampiero PorzioAlessandro ValleClaudio AdileFederica AielliFlavio FuscoCasuccio Alessandrasubject
end of lifeMalePediatricsmedicine.medical_specialtyPalliative carePainComorbiditySettore MED/42 - Igiene Generale E ApplicataPalliative sedationadvanced cancer patientPalliative sedationRisk FactorsNeoplasmsRETROSPECTIVE STUDYPrevalenceMedicineHumansHypnotics and SedativesPALLIATIVE SEDATION; advanced cancer patients; RETROSPECTIVE STUDYIntensive care medicineSurvival rateGeneral NursingSurvival analysisNursing (all)2901 Nursing (miscellaneous)Retrospective StudiesTerminal Carepalliative carebusiness.industryDeliriumRetrospective cohort studymedicine.diseaseComorbidityHome Care ServicesSurvival AnalysisSurvival RateTreatment OutcomeAnesthesiology and Pain MedicineItalyend of life; home care; palliative care; Palliative sedation; Comorbidity; Delirium; Female; Home Care Services; Humans; Hypnotics and Sedatives; Italy; Male; Neoplasms; Pain; Palliative Care; Prevalence; Retrospective Studies; Risk Factors; Survival Analysis; Survival Rate; Terminal Care; Treatment Outcome; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)MidazolamDeliriumFemaleNeurology (clinical)medicine.symptombusinesshome caremedicine.drugdescription
Abstract CONTEXT: Data regarding palliative sedation at home in dying patients are lacking. OBJECTIVES: To describe the frequency, indication, and modality of palliative sedation (PS) in patients followed at home. METHODS: A retrospective analysis of home care cancer patients was performed. Patients who received PS before dying were selected and information about epidemiologic characteristics, indications, duration, drugs, and outcomes was collected. RESULTS: Of 370 medical charts of patients who died at home, 49 patients received PS before dying. PS was proposed by the team, relatives, or both in 63.3%, 4.1%, and 32.6% of cases, respectively. Delirium alone or in combination with other symptoms was the most frequent indication to begin PS. Midazolam was the most frequently used drug to initiate PS (98%), at a mean dose of 28.1 mg/day, in combination with parenteral morphine (84.7%) at a mean dose of 25.4 mg/day. At the time of death, midazolam was administered in 98% of patients (mean dose 22.3 mg/day), combined with parenteral morphine in 87.8% of patients (mean dose 28.1 mg/day). Satisfaction for physicians and principal caregivers after PS was good in 46 and 48 cases, respectively. CONCLUSION: PS at home seems to be a feasible treatment option among selected patients and makes a potentially important contribution to improving care for those who choose to die at home.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2012-01-01 |