Vital Signs in Palliative Care: A Scoping Review

SIMPLE SUMMARY: Vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation, and temperature) are often used in healthcare settings as indicators of how unwell a patient is, and how they are responding to treatment. They are often not measured routinely for patients who are receiving palliative care. This review highlights that measuring vital signs for patients with cancer who are receiving palliative care may be of some benefit in determining prognosis, but further studies are needed to clarify the extent of association between a patient’s vital signs and prognosis. ABSTRACT: Vital signs are routinely measured in secondary healthcare settings and can be used to detect clinical problems, guide treatment, and monitor response to treatment. Vital signs are less frequently measured in palliative care settings. Reasons for this are unclear. This scoping review aimed to assess the generic use of vital signs in palliative care, and its role in prognostication for adult patients with cancer receiving palliative care. Medline, Embase, and CINAHL were searched for articles involving adult patients with advanced cancer receiving palliative care who had their vital signs measured. Twenty-six articles were identified in which one or a combination of vital signs, with or without other clinical parameters, was used to prognosticate for patients. An additional three articles investigated the generic use of vital signs in patients with advanced cancer. There was significant heterogeneity between identified studies, with some indication that changes in vital signs may indicate that a patient is close to death. However, other studies suggested that patients may maintain normal vital signs until the time of death. Further studies are needed to explore whether abnormal vital signs may be used as a prognostic indicator for patients with cancer receiving palliative care.