TY - JOUR
T1 - Palliative sedation in advanced cancer patients hospitalized in a specialized palliative care unit
AU - Parra Palacio, Santiago
AU - Giraldo Hoyos, Clara Elisa
AU - Arias Rodríguez, Camilo
AU - Mejía Arrieta, Daniel
AU - Vargas Gómez, John Jairo
AU - Krikorian, Alicia
N1 - Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Purpose: To describe the practice of palliative sedation (PS) in patients with advanced cancer in a specialized palliative care (PC) unit in Colombia. Methods: Descriptive prospective study including all adults with cancer hospitalized under PS in a cancer institute between January and July 2015 in Colombia. Variables examined were diagnosis, physical functioning, symptoms at the start of sedation, medications and dosages used, and type, level, and time of sedation. Descriptive and correlational statistics were obtained. Results: Sixty-six patients were included, 70% of which were women. The patients had an average age of 61 years (range 24–87), and 74% had a Karnofsky Index (KI) of 50% or less. The most frequent diagnosis was breast cancer (22%), and 82% had metastatic cancer. The prevalence of palliative sedation was 2% and the most common symptoms indicating it were dyspnea (59%), delirium (45%), and pain (32%). All patients received midazolam as a sedative. The average time between the interval start and culmination of sedation was 44 h. There was a significant and inverse relationship between functionality and time under sedation. Conclusions: Palliative sedation is a valid therapeutic option for refractory symptoms causing suffering. The results correspond to international reports and guidelines, which suggests that PS is tailored to the needs of the individual patient while maintaining a high scientific standard, even in a context where PC is under development. However, further development of strategies and clear indications towards the use of PS in Colombia are needed, given its still scarce use.
AB - Purpose: To describe the practice of palliative sedation (PS) in patients with advanced cancer in a specialized palliative care (PC) unit in Colombia. Methods: Descriptive prospective study including all adults with cancer hospitalized under PS in a cancer institute between January and July 2015 in Colombia. Variables examined were diagnosis, physical functioning, symptoms at the start of sedation, medications and dosages used, and type, level, and time of sedation. Descriptive and correlational statistics were obtained. Results: Sixty-six patients were included, 70% of which were women. The patients had an average age of 61 years (range 24–87), and 74% had a Karnofsky Index (KI) of 50% or less. The most frequent diagnosis was breast cancer (22%), and 82% had metastatic cancer. The prevalence of palliative sedation was 2% and the most common symptoms indicating it were dyspnea (59%), delirium (45%), and pain (32%). All patients received midazolam as a sedative. The average time between the interval start and culmination of sedation was 44 h. There was a significant and inverse relationship between functionality and time under sedation. Conclusions: Palliative sedation is a valid therapeutic option for refractory symptoms causing suffering. The results correspond to international reports and guidelines, which suggests that PS is tailored to the needs of the individual patient while maintaining a high scientific standard, even in a context where PC is under development. However, further development of strategies and clear indications towards the use of PS in Colombia are needed, given its still scarce use.
KW - Cancer
KW - Deep sedation
KW - Evaluation of symptoms
KW - Neoplasia
KW - Palliative care
KW - Terminal care
UR - http://www.scopus.com/inward/record.url?scp=85044518003&partnerID=8YFLogxK
U2 - 10.1007/s00520-018-4164-7
DO - 10.1007/s00520-018-4164-7
M3 - Artículo
C2 - 29600413
AN - SCOPUS:85044518003
SN - 0941-4355
VL - 26
SP - 3173
EP - 3180
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 9
ER -