At-home palliative sedation for end-of-life cancer patients.

Abstract:

:Using a decision-making and treatment checklist developed to facilitate the at-home palliative sedation process, we assessed the incidence and efficacy of palliative sedation for end-of-life cancer patients with intractable symptoms who died at home. We retrospectively reviewed the medical records of 370 patients who were followed by a palliative home care team. Twenty-nine of 245 patients (12%) who died at home had received palliative sedation. The mean age of the patients who received palliative sedation was 58 +/- 17 years, and the mean age of the patients who did not receive palliative sedation was 69 +/- 15 years (p = 0.002). No other differences were detected between patients who did or did not receive palliative sedation. The most common indications for palliative sedation were delirium (62%) and dyspnea (14%). Twenty-seven patients (93%) received midazolam for palliative sedation (final mean dose of 74 mg), and two (7%) received levomepromazine (final mean dose of 125 mg). The mean time between palliative sedation initiation and time of death was 2.6 days. In 13 of the cases (45%), the palliative sedation decision was made with the patient and his or her family members, and in another 13 patients (45%), the palliative sedation decision was made only with the patient's family members. We concluded that palliative sedation may be used safely and efficaciously to treat dying cancer patients with refractory symptoms at home.

journal_name

Palliat Med

journal_title

Palliative medicine

authors

Alonso-Babarro A,Varela-Cerdeira M,Torres-Vigil I,Rodríguez-Barrientos R,Bruera E

doi

10.1177/0269216309359996

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

486-92

issue

5

eissn

0269-2163

issn

1477-030X

pii

0269216309359996

journal_volume

24

pub_type

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