Palliative Sedation in Patients Hospitalized in Internal Medicine Departments
Díez-Manglano, Jesús (Universidad de Zaragoza) ; Isasi de Isasmendi Pérez, Soledad ; García Fenoll, Rosa (Universidad de Zaragoza) ; Sánchez, Luis Ángel ; Formiga, Françesc ; Giner Galvañ, Vicente ; Dueñas, Carlos ; Roca, Bernardino ; Estrada Díaz, Cristina ; Casariego Vales, Emilio
Resumen: Context
Palliative sedation is used to relieve end-of-life refractory symptoms.
Objective
The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments.
Methods
An observational, cross-sectional, retrospective, and multicenter clinical audit study was conducted in 145 hospitals in Spain and Argentina. Each hospital included the first 10 patients who died in the internal medicine department, starting on December 1, 2015.
Results
We included 1447 patients, and palliative sedation was administered to 701 patients (48.4%). Having a terminal illness (odds ratio [OR] 2.469, 95% CI 1.971–3.093, P < 0.001) and the length of hospital stay (OR 1.011, 95% CI 1.002–1.021, P = 0.017) were independently associated with the use of palliative sedation. Consent was granted by the families of 582 (83%) patients. The most common refractory symptom was dyspnea, and the most commonly used drugs for sedation were midazolam (77%) and morphine (89.7%). An induction dose was administered in 25.7% of the patients. Rescue doses were scheduled for 70% of the patients, and hydration was maintained in 49.5%. Pain was more common in patients with cancer, whereas dyspnea was more common in those without cancer. Rescue doses were used more often for the patients with cancer (77.8% vs. 67.7%, P = 0.015). Monitoring the palliative sedation with a scale was more frequent in the patients with cancer (23.7% vs. 14.3%, P = 0.008).
Conclusions
Palliative sedation is used more often for terminal patients. There are differences in the administration of palliative sedation between patients with and without cancer.
Idioma: Inglés
DOI: 10.1016/j.jpainsymman.2019.10.013
Año: 2020
Publicado en: JOURNAL OF PAIN AND SYMPTOM MANAGEMENT 59, 2 (2020), 302-309
ISSN: 0885-3924
Factor impacto JCR: 3.612 (2020)
Categ. JCR: CLINICAL NEUROLOGY rank: 85 / 208 = 0.409 (2020) - Q2 - T2
Categ. JCR: MEDICINE, GENERAL & INTERNAL rank: 47 / 167 = 0.281 (2020) - Q2 - T1
Categ. JCR: HEALTH CARE SCIENCES & SERVICES rank: 33 / 107 = 0.308 (2020) - Q2 - T1
Factor impacto SCIMAGO: 1.437 - Anesthesiology and Pain Medicine (Q1) - Nursing (miscellaneous) (Q1) - Neurology (clinical) (Q1)
Tipo y forma: Article (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
Exportado de SIDERAL (2024-02-09-14:31:44)
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Palliative sedation is used to relieve end-of-life refractory symptoms.
Objective
The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments.
Methods
An observational, cross-sectional, retrospective, and multicenter clinical audit study was conducted in 145 hospitals in Spain and Argentina. Each hospital included the first 10 patients who died in the internal medicine department, starting on December 1, 2015.
Results
We included 1447 patients, and palliative sedation was administered to 701 patients (48.4%). Having a terminal illness (odds ratio [OR] 2.469, 95% CI 1.971–3.093, P < 0.001) and the length of hospital stay (OR 1.011, 95% CI 1.002–1.021, P = 0.017) were independently associated with the use of palliative sedation. Consent was granted by the families of 582 (83%) patients. The most common refractory symptom was dyspnea, and the most commonly used drugs for sedation were midazolam (77%) and morphine (89.7%). An induction dose was administered in 25.7% of the patients. Rescue doses were scheduled for 70% of the patients, and hydration was maintained in 49.5%. Pain was more common in patients with cancer, whereas dyspnea was more common in those without cancer. Rescue doses were used more often for the patients with cancer (77.8% vs. 67.7%, P = 0.015). Monitoring the palliative sedation with a scale was more frequent in the patients with cancer (23.7% vs. 14.3%, P = 0.008).
Conclusions
Palliative sedation is used more often for terminal patients. There are differences in the administration of palliative sedation between patients with and without cancer.
Idioma: Inglés
DOI: 10.1016/j.jpainsymman.2019.10.013
Año: 2020
Publicado en: JOURNAL OF PAIN AND SYMPTOM MANAGEMENT 59, 2 (2020), 302-309
ISSN: 0885-3924
Factor impacto JCR: 3.612 (2020)
Categ. JCR: CLINICAL NEUROLOGY rank: 85 / 208 = 0.409 (2020) - Q2 - T2
Categ. JCR: MEDICINE, GENERAL & INTERNAL rank: 47 / 167 = 0.281 (2020) - Q2 - T1
Categ. JCR: HEALTH CARE SCIENCES & SERVICES rank: 33 / 107 = 0.308 (2020) - Q2 - T1
Factor impacto SCIMAGO: 1.437 - Anesthesiology and Pain Medicine (Q1) - Nursing (miscellaneous) (Q1) - Neurology (clinical) (Q1)
Tipo y forma: Article (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2024-02-09-14:31:44)
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Record created 2024-02-09, last modified 2024-02-09