TY - JOUR
T1 - At-home palliative sedation for end-of-life cancer patients
AU - Alonso-Babarro, Alberto
AU - Varela-Cerdeira, Maria
AU - Torres-Vigil, Isabel
AU - Rodríguez-Barrientos, Ricardo
AU - Bruera, Eduardo
PY - 2010/7
Y1 - 2010/7
N2 - 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 patients family members. We concluded that palliative sedation may be used safely and efficaciously to treat dying cancer patients with refractory symptoms at home.
AB - 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 patients family members. We concluded that palliative sedation may be used safely and efficaciously to treat dying cancer patients with refractory symptoms at home.
KW - Palliative sedation
KW - end-of-life care
KW - home care
KW - midazolam
KW - palliative care
KW - terminal care
UR - http://www.scopus.com/inward/record.url?scp=77953972224&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953972224&partnerID=8YFLogxK
U2 - 10.1177/0269216309359996
DO - 10.1177/0269216309359996
M3 - Article
C2 - 20133320
AN - SCOPUS:77953972224
SN - 0269-2163
VL - 24
SP - 486
EP - 492
JO - Palliative Medicine
JF - Palliative Medicine
IS - 5
ER -