Association between continuous deep sedation and survival time in terminally ill cancer patients

被引:10
作者
Park, So-Jung [1 ]
Ahn, Hee Kyung [2 ]
Ahn, Hong Yup [3 ]
Han, Kyu-Tae [1 ]
Hwang, Cheol [4 ]
机构
[1] Natl Canc Ctr, Natl Hosp Ctr, Goyang, South Korea
[2] Gachon Univ, Gil Med Ctr, Div Med Oncol, Dept Internal Med,Coll Med, Incheon, South Korea
[3] Dongguk Univ, Dept Stat, Seoul, South Korea
[4] Gachon Univ, Gil Med Ctr, Dept Family Med, Coll Med, 1198 Guwol Dong, Incheon 405760, South Korea
关键词
Continuous deep sedation; Palliative sedation; Survival; Sedative; Palliative care; Hospice; PALLIATIVE SEDATION; REFRACTORY SYMPTOMS; CARE; END; LIFE; NETHERLANDS; DEATH; PAIN;
D O I
10.1007/s00520-020-05516-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Our study aimed to evaluate the association between CDS and survival time using the likelihood of receiving CDS to select a matched non-CDS group through an accurate measurement of survival time based on initiation of CDS. Methods A retrospective cohort study was performed using an electronic database to collect data regarding terminally ill cancer patients admitted to a specialized palliative care unit from January 2012 to December 2016. We first used a Cox proportional hazard model with receiving CDS as the outcome to identify individuals with the highest plausibility of receiving CDS among the non-CDS group (n = 663). We then performed a multiple regression analysis comparing the CDS group (n = 311) and weighted non-CDS group (n = 311), using initiation of CDS (actual for the CDS group; estimated for the non-CDS group) as the starting time-point for measuring survival time. Results Approximately 32% of participants received CDS. The most common indications were delirium or agitation (58.2%), intractable pain (28.9%), and dyspnea (10.6%). Final multiple regression analysis revealed that survival time was longer in the CDS group than in the non-CDS group (Exp(beta), 1.41; P < 0.001). Longer survival with CDS was more prominent in females, patients with renal dysfunction, and individuals with low C-reactive protein (CRP) or ferritin, compared with their counterpart subgroup. Conclusions CDS was not associated with shortened survival; instead, it was associated with longer survival in our terminally ill cancer patients. Further studies in other populations are required to confirm or refute these findings.
引用
收藏
页码:525 / 531
页数:7
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