Association Between Continuous Deep Sedation and Survival Time in Terminally Ill Cancer Patients

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2020 May 17

PMID 32415383

Citations 8

Authors

So-Jung Park

Hee Kyung Ahn

Hong Yup Ahn

Kyu-Tae Han

In Cheol Hwang

Affiliations

Soon will be listed here.

Abstract

Purpose: Our study aimed to evaluate the association between CDS and survival time using the likelihood of receiving CDS to select a matched non-CDS group through an accurate measurement of survival time based on initiation of CDS.

Methods: A retrospective cohort study was performed using an electronic database to collect data regarding terminally ill cancer patients admitted to a specialized palliative care unit from January 2012 to December 2016. We first used a Cox proportional hazard model with receiving CDS as the outcome to identify individuals with the highest plausibility of receiving CDS among the non-CDS group (n = 663). We then performed a multiple regression analysis comparing the CDS group (n = 311) and weighted non-CDS group (n = 311), using initiation of CDS (actual for the CDS group; estimated for the non-CDS group) as the starting time-point for measuring survival time.

Results: Approximately 32% of participants received CDS. The most common indications were delirium or agitation (58.2%), intractable pain (28.9%), and dyspnea (10.6%). Final multiple regression analysis revealed that survival time was longer in the CDS group than in the non-CDS group (Exp(β), 1.41; P < 0.001). Longer survival with CDS was more prominent in females, patients with renal dysfunction, and individuals with low C-reactive protein (CRP) or ferritin, compared with their counterpart subgroup.

Conclusions: CDS was not associated with shortened survival; instead, it was associated with longer survival in our terminally ill cancer patients. Further studies in other populations are required to confirm or refute these findings.

Citing Articles

[New recommendations on palliative sedation].

Surges S, Brunsch H, Przyborek M, Jaspers B, Radbruch L Schmerz. 2024; 38(5):365-373.

PMID: 39264452 PMC: 11420285. DOI: 10.1007/s00482-024-00825-x.

Current Status and Future Directions of Research on Palliative Sedation.

Hwang I J Hosp Palliat Care. 2023; 25(4):193-197.

PMID: 37674671 PMC: 10179994. DOI: 10.14475/jhpc.2022.25.4.193.

Characteristics Associated with Survival in Patients Receiving Continuous Deep Sedation in a Hospice Care Unit.

Ahn H, Ahn H, Park S, Hwang I J Hosp Palliat Care. 2023; 24(4):254-260.

PMID: 37674644 PMC: 10180067. DOI: 10.14475/jhpc.2021.24.4.254.

Continuous palliative sedation in terminally ill patients with cancer: a retrospective observational cohort study from a Chinese palliative care unit.

Tan F, Chen S, Huang L, Chen Y, Wu Y BMJ Open. 2023; 13(5):e071859.

PMID: 37230518 PMC: 10230991. DOI: 10.1136/bmjopen-2023-071859.

Comparison of survival times of advanced cancer patients with palliative care at home and in hospital.

Hamano J, Takeuchi A, Mori M, Saitou Y, Yamaguchi T, Miyata N PLoS One. 2023; 18(4):e0284147.

PMID: 37053183 PMC: 10101528. DOI: 10.1371/journal.pone.0284147.

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