Continuous palliative sedation for patients with advanced cancer at a tertiary care cancer center

• Published in: BMC palliative care 2018-01, Vol.17 (1), p.13-13, Article 13
• Main Authors: Prado, Bernard Lobato, Gomes, Diogo Bugano Diniz, Usón Júnior, Pedro Luiz Serrano, Taranto, Patricia, França, Monique Sedlmaier, Eiger, Daniel, Mariano, Rodrigo Coutinho, Hui, David, Del Giglio, Auro
• Format: Article
• Language: English
• Subjects: Advanced cancer; Aged; Aged, 80 and over; Analysis of Variance; Anesthesia; Cancer patients; Consciousness; Continuous palliative sedation; Deep Sedation - methods; Deep Sedation - trends; Delirium; Delirium - drug therapy; Demographics; Drug dosages; Dyspnea; Dyspnea - drug therapy; Female; Health aspects; Hematology; Hospice care; Hospitals; Humans; Hypnotics; Hypnotics and Sedatives - therapeutic use; Intensive Care Units - organization & administration; Length of stay; Lung cancer; Male; Midazolam; Midazolam - therapeutic use; Middle Aged; Neoplasms - complications; Neuroleptics; Oncology; Pain; Pain Management - methods; Palliative care; Palliative Care - methods; Palliative treatment; Patients; Population; Retrospective Studies; Sedatives; Survival; Survival analysis; Tertiary care; Tertiary Care Centers - organization & administration; Ventilators
• ISSN: 1472-684X; 1472-684X
• DOI: 10.1186/s12904-017-0264-2

Palliative sedation (PS) is an intervention to treat refractory symptoms and to relieve suffering at the end of life. Its prevalence and practice patterns vary widely worldwide. The aim of our study was to evaluate the frequency, clinical indications and outcomes of PS in advanced cancer patients admitted to our tertiary comprehensive cancer center. We retrospectively studied the use of PS in advanced cancer patients who died between March 1st, 2012 and December 31st, 2014. PS was defined as the use of continuous infusion of midazolam or neuroleptics for refractory symptoms in the end of life. This study was approved by the Research Ethics Committee of our institution (project number 2481-15). During the study period, 552 cancer patients died at the institution and 374 met the inclusion criteria for this study. Main reason for exclusion was death in the Intensive Care Unit. Among all included patients, 54.2% (n = 203) received PS. Patients who received PS as compared to those not sedated were younger (67.8 vs. 76.4 years-old, p