Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Characteristics Associated with Survival in Patients Receiving Continuous Deep Sedation in a Hospice Care Unit

  • Ahn, Hee Kyung (Oncology Division, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine) ;
  • Ahn, Hong Yup (Department of Statistics, Dongguk University) ;
  • Park, So Jung (National Hospice Center) ;
  • Hwang, In Cheol (Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine)
  • Received : 2021.07.21
  • Accepted : 2021.09.30
  • Published : 2021.12.01
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Abstract

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

Keywords

Acknowledgement

This work was supported by the Gachon University Gil Medical Center (Grant number: FRD2021-14).

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