Abstract:
OBJECTIVE:Most cancer patients become increasingly anxious toward the end of their life. The objective of this study was to identify predictors of increased opioid dosage in the last week of a terminal cancer patient's life. METHODS:We retrospectively reviewed charts of patients who died in our palliative care unit. We assigned the patients to increased group or decreased group according to changes in oral morphine equivalent dosage in their last 7 days. Logistic regression analysis was used to identify predictors of increased oral morphine equivalent dosage. RESULTS:We analyzed data of 158 patients (female: 43.7%, median age: 64 years). The median oral morphine equivalent dosages on Days 7 and 1 before death were 50 mg (interquartile range: 24-122) and 61 mg (28-129), respectively. Independent predictors of increased oral morphine equivalent dosage included dyspnea (odds ratio: 11.5, 95% confidence interval: 4.98-28.83, P < 0.01), age <65 years (odds ratio: 2.3, 95% confidence interval: 1.04-5.26, P = 0.04) and oral morphine equivalent dosage <50 mg on Day 7 before death (odds ratio: 3.7, 95% confidence interval: 1.68-8.89, P < 0.01). The median oral morphine equivalent dosages on Days 7 and 1 before death were 48 mg (interquartile range: 20-126) and 75 mg (36-170) in patients with dyspnea, and 50 mg (25-120) and 57 mg (25-124) in patients with pain, respectively. CONCLUSIONS:Dyspnea, relative youth and oral morphine equivalent dosage <50 mg on Day 7 before death were predictive of increased oral morphine equivalent dosage in the last 7 days. Our findings may help oncologists to more accurately inform patients about expected opioid requirements and thus relieve their end-of-life anxiety.
journal_name
Jpn J Clin Oncoljournal_title
Japanese journal of clinical oncologyauthors
Miura T,Matsumoto Y,Motonaga S,Hasuo H,Abe K,Kinoshita Hdoi
10.1093/jjco/hyu137subject
Has Abstractpub_date
2014-11-01 00:00:00pages
1082-7issue
11eissn
0368-2811issn
1465-3621pii
hyu137journal_volume
44pub_type
杂志文章abstract::A Phase II trial was initiated in Japan to evaluate the efficacy and safety of preoperative chemotherapy with docetaxel, cisplatin and S-1 for gastric cancer with extensive lymph node metastasis. Patients are eligible to participate in the study if they have para-aortic lymph node metastases (stations no. 16a2/16b1) a...
journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,多中心研究
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