Cargando…
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...
Autores principales: | , , , , , |
---|---|
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 |
_version_ | 1782367224160321536 |
---|---|
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. |
format | Online Article Text |
id | pubmed-4402068 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BlackWell Publishing Ltd |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT guirimandfrederic sequentialoccurrenceofdyspneaattheendoflifeinpalliativecareaccordingtotheunderlyingcancer AT sahutdizarnmarine sequentialoccurrenceofdyspneaattheendoflifeinpalliativecareaccordingtotheunderlyingcancer AT laportelucy sequentialoccurrenceofdyspneaattheendoflifeinpalliativecareaccordingtotheunderlyingcancer AT francillardmarie sequentialoccurrenceofdyspneaattheendoflifeinpalliativecareaccordingtotheunderlyingcancer AT richardjeanfrancois sequentialoccurrenceofdyspneaattheendoflifeinpalliativecareaccordingtotheunderlyingcancer AT aegerterphilippe sequentialoccurrenceofdyspneaattheendoflifeinpalliativecareaccordingtotheunderlyingcancer |