Journal of Hospice and Palliative Care
- Volume 11 Issue 2
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- Pages.99-105
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- 2008
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- 2765-3072(pISSN)
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- 2765-3080(eISSN)
Clinical Change of Terminally Ill Cancer Patients at the End-of-life Time
임종 전 말기 암 환자의 임상 증상 및 징후의 변화
- Koh, Su-Jin (Department of Internal Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Lee, Kyung-Shik (Department of Internal Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Hong, Yeong-Seon (Department of Internal Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Yoo, Yang-Sook (The Catholic University of Korea College of Nursing) ;
- Park, Hyea-Ja (Yonginsi Senior Welfare Center)
- 고수진 (가톨릭대학교 의과대학 강남성모병원 내과학교실) ;
- 이경식 (가톨릭대학교 의과대학 강남성모병원 내과학교실) ;
- 홍영선 (가톨릭대학교 의과대학 강남성모병원 내과학교실) ;
- 유양숙 (가톨릭대학교 간호학과) ;
- 박혜자 (용인시 노인복지회관)
- Published : 2008.07.01
Abstract
Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients. Methods: We enrolled the terminal cancer patients from Kangnam St. Mary's Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use. Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death. Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.
목적: 본 연구에서는 호스피스 병동에 입원한 말기 암 환자들을 대상으로 임상적으로 보다 정확한 잔여 수명을 예측하고자 임종의 시기에 객관적으로 임상적 증상 및 징후들의 변화를 관찰하였다. 방법: 강남성모병원 호스피스센터를 방분한 말기 암 환자를 대상으로 입원 시부터 임종까지 말기에 흔히 나타나는 증상과 신체적 징후의 변화를 관찰하였다. 증상의 정도는