title: Palliative sedation in a southern Appalachian community.
abstract: Of 1200 palliative care patients, 28 received palliative sedation. They were more likely than patients without palliative sedation to have an Eastern Cooperative Oncology Group performance status of at least 3, a cancer diagnosis, an expected survival of weeks or less, to have been monitored by the palliative care team for at least 1 week, to have delirium as the cause of decreased communication, to have dyspnea as a non-pain symptom, and to be less able to communicate symptoms. Almost 90% received palliative sedation for at least 24 hours for a median of 3 days (range, 0 to 24 days). Home patients received palliative sedation longer. Symptoms were controlled in 82% and improved in the rest. Sedation developed in 79% but was not required for symptom control in 5. Patient survival from palliative care consultation was a median of 8 days (range, 0 to 32 days).
authors.affiliation: Palliative Care and Hospice, Advanced Illness Assistance Team, Blount Memorial Hospital, Maryville, Tennessee. jcowan@bmnet.com.
authors.forename: John D
authors.initials: JD
authors.lastname: Cowan
authors.forename: Libby
authors.initials: L
authors.lastname: Clemens
authors.forename: Teresa
authors.initials: T
authors.lastname: Palmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality; D016292:Procedural Sedation / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D004417:Dyspnea / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006302:Health Services Research; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000401:mortality; D010146:Pain / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D010166:Palliative Care / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013714:Tennessee / Q000453:epidemiology