Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.

CONTEXT: Palliative sedation is used to relieve end-of-life refractory symptoms. OBJECTIVE: The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments. METHODS: An observational, cross-sectional, retrospective, and multicenter clin...

Full description

Bibliographic Details
Authors: Díez-Manglano J, Isasi de Isasmendi Pérez S, García Fenoll R, Sánchez LÁ, Formiga F, Giner Galvañ V, Dueñas C, Roca B, Estrada Díaz C, Casariego Vales E
Format: article
Status:Published version
Publication Date:2020
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p4865
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/4865
Access Level:Open access
Keyword:Palliative sedation
internal medicine
palliative care
terminal care
id ES_f044b32555bbb2417d88feef2fe1b5e7
oai_identifier_str oai:fisabio.fundanetsuite.com:p4865
network_acronym_str ES
network_name_str España
repository_id_str
spelling Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.Díez-Manglano JIsasi de Isasmendi Pérez SGarcía Fenoll RSánchez LÁFormiga FGiner Galvañ VDueñas CRoca BEstrada Díaz CCasariego Vales EPalliative sedationinternal medicinepalliative careterminal careCONTEXT: Palliative sedation is used to relieve end-of-life refractory symptoms. OBJECTIVE: The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments. METHODS: An observational, cross-sectional, retrospective, and multicenter clinical audit study was conducted in 145 hospitals in Spain and Argentina. Each hospital included the first 10 patients who died in the internal medicine department, starting on December 1, 2015. RESULTS: We included 1447 patients, and palliative sedation was administered to 701 patients (48.4%). Having a terminal illness (odds ratio [OR] 2.469, 95% CI 1.971-3.093, P < 0.001) and the length of hospital stay (OR 1.011, 95% CI 1.002-1.021, P = 0.017) were independently associated with the use of palliative sedation. Consent was granted by the families of 582 (83%) patients. The most common refractory symptom was dyspnea, and the most commonly used drugs for sedation were midazolam (77%) and morphine (89.7%). An induction dose was administered in 25.7% of the patients. Rescue doses were scheduled for 70% of the patients, and hydration was maintained in 49.5%. Pain was more common in patients with cancer, whereas dyspnea was more common in those without cancer. Rescue doses were used more often for the patients with cancer (77.8% vs. 67.7%, P = 0.015). Monitoring the palliative sedation with a scale was more frequent in the patients with cancer (23.7% vs. 14.3%, P = 0.008). CONCLUSIONS: Palliative sedation is used more often for terminal patients. There are differences in the administration of palliative sedation between patients with and without cancer.ELSEVIER SCIENCE INC2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/4865JOURNAL OF PAIN AND SYMPTOM MANAGEMENTISSN: 08853924ISSNe: 18736513reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p48652026-06-11T12:45:17Z
dc.title.none.fl_str_mv Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
title Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
spellingShingle Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
Díez-Manglano J
Palliative sedation
internal medicine
palliative care
terminal care
title_short Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
title_full Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
title_fullStr Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
title_full_unstemmed Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
title_sort Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
dc.creator.none.fl_str_mv Díez-Manglano J
Isasi de Isasmendi Pérez S
García Fenoll R
Sánchez LÁ
Formiga F
Giner Galvañ V
Dueñas C
Roca B
Estrada Díaz C
Casariego Vales E
author Díez-Manglano J
author_facet Díez-Manglano J
Isasi de Isasmendi Pérez S
García Fenoll R
Sánchez LÁ
Formiga F
Giner Galvañ V
Dueñas C
Roca B
Estrada Díaz C
Casariego Vales E
author_role author
author2 Isasi de Isasmendi Pérez S
García Fenoll R
Sánchez LÁ
Formiga F
Giner Galvañ V
Dueñas C
Roca B
Estrada Díaz C
Casariego Vales E
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Palliative sedation
internal medicine
palliative care
terminal care
topic Palliative sedation
internal medicine
palliative care
terminal care
description CONTEXT: Palliative sedation is used to relieve end-of-life refractory symptoms. OBJECTIVE: The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments. METHODS: An observational, cross-sectional, retrospective, and multicenter clinical audit study was conducted in 145 hospitals in Spain and Argentina. Each hospital included the first 10 patients who died in the internal medicine department, starting on December 1, 2015. RESULTS: We included 1447 patients, and palliative sedation was administered to 701 patients (48.4%). Having a terminal illness (odds ratio [OR] 2.469, 95% CI 1.971-3.093, P < 0.001) and the length of hospital stay (OR 1.011, 95% CI 1.002-1.021, P = 0.017) were independently associated with the use of palliative sedation. Consent was granted by the families of 582 (83%) patients. The most common refractory symptom was dyspnea, and the most commonly used drugs for sedation were midazolam (77%) and morphine (89.7%). An induction dose was administered in 25.7% of the patients. Rescue doses were scheduled for 70% of the patients, and hydration was maintained in 49.5%. Pain was more common in patients with cancer, whereas dyspnea was more common in those without cancer. Rescue doses were used more often for the patients with cancer (77.8% vs. 67.7%, P = 0.015). Monitoring the palliative sedation with a scale was more frequent in the patients with cancer (23.7% vs. 14.3%, P = 0.008). CONCLUSIONS: Palliative sedation is used more often for terminal patients. There are differences in the administration of palliative sedation between patients with and without cancer.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/4865
url https://fisabio.portalinvestigacion.com/publicaciones/4865
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
ISSN: 08853924
ISSNe: 18736513
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869423941167087616
score 15.811543

Similar Items