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“3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study
BACKGROUND: The study aimed to clarify the efficacy of the “3‐Day Surprise Question (3DSQ)” in predicting the prognosis for advanced cancer patients with impending death. PATIENTS AND METHODS: This study was a part of multicenter prospective observational study which investigated the dying process i...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897938/ https://www.ncbi.nlm.nih.gov/pubmed/33347734 http://dx.doi.org/10.1002/cam4.3689 |
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author | Ikari, Tomoo Hiratsuka, Yusuke Yamaguchi, Takuhiro Maeda, Isseki Mori, Masanori Uneno, Yu Taniyama, Tomohiko Matsuda, Yosuke Oya, Kiyofumi Tagami, Keita Inoue, Akira |
author_facet | Ikari, Tomoo Hiratsuka, Yusuke Yamaguchi, Takuhiro Maeda, Isseki Mori, Masanori Uneno, Yu Taniyama, Tomohiko Matsuda, Yosuke Oya, Kiyofumi Tagami, Keita Inoue, Akira |
author_sort | Ikari, Tomoo |
collection | PubMed |
description | BACKGROUND: The study aimed to clarify the efficacy of the “3‐Day Surprise Question (3DSQ)” in predicting the prognosis for advanced cancer patients with impending death. PATIENTS AND METHODS: This study was a part of multicenter prospective observational study which investigated the dying process in advanced cancer patients in Japan. For patients with a Palliative Performance Scale ≤20, the 3DSQ “Would I be surprised if this patient died in the next 3 days?” was answered by their physicians. In addition to the sensitivity and specificity of the 3DSQ, the characteristics of patients who survived longer than expected were examined via multivariate analysis. RESULTS: Among the 1896 patients enrolled, 1411 were evaluated. Among 1179 (83.6%) patients who were classified into the “Not surprised” group, 636 patients died within 3 days. Among 232 (16.4%) patients of “Yes surprised” group, 194 patients lived longer than 3 days. The sensitivity, specificity, positive predictive value, and negative predictive value of the 3DSQ were 94.3% (95% confidence interval [CI]: 92.7% to 95.8%), 26.3% (95% CI: 24.8% to 27.6%), 53.9% (95% CI: 53.0% to 54.7%), and 83.6% (95% CI: 78.7% to 87.7%), respectively. Multivariate analysis showed palpable radial artery, absent respiration with mandibular movement, SpO(2) ≥ 90%, opioid administration, and no continuous deep sedation as characteristics of patients who lived longer than expected. CONCLUSIONS: The 3‐Day Surprise Question can be a useful screening tool to identify advanced cancer patients with impending death. |
format | Online Article Text |
id | pubmed-7897938 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78979382021-02-23 “3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study Ikari, Tomoo Hiratsuka, Yusuke Yamaguchi, Takuhiro Maeda, Isseki Mori, Masanori Uneno, Yu Taniyama, Tomohiko Matsuda, Yosuke Oya, Kiyofumi Tagami, Keita Inoue, Akira Cancer Med Clinical Cancer Research BACKGROUND: The study aimed to clarify the efficacy of the “3‐Day Surprise Question (3DSQ)” in predicting the prognosis for advanced cancer patients with impending death. PATIENTS AND METHODS: This study was a part of multicenter prospective observational study which investigated the dying process in advanced cancer patients in Japan. For patients with a Palliative Performance Scale ≤20, the 3DSQ “Would I be surprised if this patient died in the next 3 days?” was answered by their physicians. In addition to the sensitivity and specificity of the 3DSQ, the characteristics of patients who survived longer than expected were examined via multivariate analysis. RESULTS: Among the 1896 patients enrolled, 1411 were evaluated. Among 1179 (83.6%) patients who were classified into the “Not surprised” group, 636 patients died within 3 days. Among 232 (16.4%) patients of “Yes surprised” group, 194 patients lived longer than 3 days. The sensitivity, specificity, positive predictive value, and negative predictive value of the 3DSQ were 94.3% (95% confidence interval [CI]: 92.7% to 95.8%), 26.3% (95% CI: 24.8% to 27.6%), 53.9% (95% CI: 53.0% to 54.7%), and 83.6% (95% CI: 78.7% to 87.7%), respectively. Multivariate analysis showed palpable radial artery, absent respiration with mandibular movement, SpO(2) ≥ 90%, opioid administration, and no continuous deep sedation as characteristics of patients who lived longer than expected. CONCLUSIONS: The 3‐Day Surprise Question can be a useful screening tool to identify advanced cancer patients with impending death. John Wiley and Sons Inc. 2020-12-21 /pmc/articles/PMC7897938/ /pubmed/33347734 http://dx.doi.org/10.1002/cam4.3689 Text en © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Ikari, Tomoo Hiratsuka, Yusuke Yamaguchi, Takuhiro Maeda, Isseki Mori, Masanori Uneno, Yu Taniyama, Tomohiko Matsuda, Yosuke Oya, Kiyofumi Tagami, Keita Inoue, Akira “3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study |
title | “3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study |
title_full | “3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study |
title_fullStr | “3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study |
title_full_unstemmed | “3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study |
title_short | “3‐Day Surprise Question” to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study |
title_sort | “3‐day surprise question” to predict prognosis of advanced cancer patients with impending death: multicenter prospective observational study |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897938/ https://www.ncbi.nlm.nih.gov/pubmed/33347734 http://dx.doi.org/10.1002/cam4.3689 |
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