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Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer

Dyspnea is a symptom that severely affects the quality of life of terminally ill patients. Its frequency differs considerably between studies. We aimed to characterize the frequency of dyspnea in a palliative care hospital (PCH) and to identify factors predisposing to dyspnea, particularly during th...

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Autores principales: Guirimand, Frédéric, Sahut d'izarn, Marine, Laporte, Lucy, Francillard, Marie, Richard, Jean-François, Aegerter, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BlackWell Publishing Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402068/
https://www.ncbi.nlm.nih.gov/pubmed/25644607
http://dx.doi.org/10.1002/cam4.419
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author Guirimand, Frédéric
Sahut d'izarn, Marine
Laporte, Lucy
Francillard, Marie
Richard, Jean-François
Aegerter, Philippe
author_facet Guirimand, Frédéric
Sahut d'izarn, Marine
Laporte, Lucy
Francillard, Marie
Richard, Jean-François
Aegerter, Philippe
author_sort Guirimand, Frédéric
collection PubMed
description Dyspnea is a symptom that severely affects the quality of life of terminally ill patients. Its frequency differs considerably between studies. We aimed to characterize the frequency of dyspnea in a palliative care hospital (PCH) and to identify factors predisposing to dyspnea, particularly during the very last days of life, as a function of the underlying disease. Episodes of dyspnea were identified by the computerized extraction of prospectively collected data from the reports of care assistants or from medical observations recorded in the medical files for all stays at our PCH during the last 6 years. There were 6455 hospital stays, 88% ending in the death of the patient; 13,282 episodes of dyspnea were recorded during 2608 hospital stays (40%). Dyspnea was more frequently observed in cases of cancer than in other conditions (RR = 1.30; 95% CI: 1.14–1.48). Pulmonary metastasis increased the risk of dyspnea from 37% to 51% (RR = 1.37; 95% CI: 1.29–1.46). Dyspnea frequency varied with the primary cancer site, from 24% (brain cancer) to 60% (esophageal cancer). The data for cancer patients staying for more than 6 days who subsequently died indicated that 8% of patients experienced dyspnea exclusively during the last 4 days of the life, independently of the site of the primary cancer. Dyspnea during the last few days of life requires systematic assessment. Exclusively terminal dyspnea should be distinguished from more precocious dyspnea, as the pathophysiological mechanisms and treatments of these two forms are probably different.
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spelling pubmed-44020682015-04-23 Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer Guirimand, Frédéric Sahut d'izarn, Marine Laporte, Lucy Francillard, Marie Richard, Jean-François Aegerter, Philippe Cancer Med Cancer Research Dyspnea is a symptom that severely affects the quality of life of terminally ill patients. Its frequency differs considerably between studies. We aimed to characterize the frequency of dyspnea in a palliative care hospital (PCH) and to identify factors predisposing to dyspnea, particularly during the very last days of life, as a function of the underlying disease. Episodes of dyspnea were identified by the computerized extraction of prospectively collected data from the reports of care assistants or from medical observations recorded in the medical files for all stays at our PCH during the last 6 years. There were 6455 hospital stays, 88% ending in the death of the patient; 13,282 episodes of dyspnea were recorded during 2608 hospital stays (40%). Dyspnea was more frequently observed in cases of cancer than in other conditions (RR = 1.30; 95% CI: 1.14–1.48). Pulmonary metastasis increased the risk of dyspnea from 37% to 51% (RR = 1.37; 95% CI: 1.29–1.46). Dyspnea frequency varied with the primary cancer site, from 24% (brain cancer) to 60% (esophageal cancer). The data for cancer patients staying for more than 6 days who subsequently died indicated that 8% of patients experienced dyspnea exclusively during the last 4 days of the life, independently of the site of the primary cancer. Dyspnea during the last few days of life requires systematic assessment. Exclusively terminal dyspnea should be distinguished from more precocious dyspnea, as the pathophysiological mechanisms and treatments of these two forms are probably different. BlackWell Publishing Ltd 2015-04 2015-01-30 /pmc/articles/PMC4402068/ /pubmed/25644607 http://dx.doi.org/10.1002/cam4.419 Text en © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. http://creativecommons.org/licenses/by/4.0/ This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Research
Guirimand, Frédéric
Sahut d'izarn, Marine
Laporte, Lucy
Francillard, Marie
Richard, Jean-François
Aegerter, Philippe
Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer
title Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer
title_full Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer
title_fullStr Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer
title_full_unstemmed Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer
title_short Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer
title_sort sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer
topic Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402068/
https://www.ncbi.nlm.nih.gov/pubmed/25644607
http://dx.doi.org/10.1002/cam4.419
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