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Supportive Care in Cancer
Published in: Supportive Care in Cancer 6/2012

01-06-2012 | Original Article

Palliative sedation at the end of life at a tertiary cancer center

Authors: Augusto Caraceni, Ernesto Zecca, Cinzia Martini, Giovanna Gorni, Tiziana Campa, Cinzia Brunelli, Franco De Conno

Published in: Supportive Care in Cancer | Issue 6/2012

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Abstract

Purpose

The aim of this study was to describe the use of palliative sedation (PS) its indications and outcomes in patients followed up till death by an inpatient palliative care consult team (PCCT) at a tertiary cancer center.

Methods

All patients referred for 5 years to the PCCT and followed up till death were eligible for the study. Both PCCT recordings and hospital charts were reviewed and a codified assessment was performed.

Results

Over a total of 2,033 consecutive consults, 129 patients died during admission and were eligible. Eighty-three had the indication to PS, 4% of all consults (95% confidence interval [95%CI], 3% to 5%) and 64% of eligible patients (95%CI, 56% to 73%). PS was more frequently indicated in males and in patients with recurrent dyspnea and recurrent agitation, while it was less frequently indicated in older people and in patients with cerebral metastases and recurrent drowsiness. The most frequent indications to PS were dyspnea (37%) and delirium (31%) alone or combined with other symptoms. PS was successfully achieved in 69 patients; the drugs most frequently used for PS were midazolam (46%), haloperidol (35%), and chlorpromazine (32%) and opioid dose escalation was higher in sedated patients (P < 0.01).

Conclusions

PS is an important intervention in the management of terminal disease by a consulting palliative care team. Improved collaboration and communication between the hospital staff and the PCCT should be offered to meet patients’ needs when PS is required.
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Metadata
Title
Palliative sedation at the end of life at a tertiary cancer center
Authors
Augusto Caraceni
Ernesto Zecca
Cinzia Martini
Giovanna Gorni
Tiziana Campa
Cinzia Brunelli
Franco De Conno
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 6/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-011-1217-6

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