Palliative sedation in a southern Appalachian community.
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).
Cowan
John D
JD
Palliative Care and Hospice, Advanced Illness Assistance Team, Blount Memorial Hospital, Maryville, Tennessee. jcowan@bmnet.com.
Clemens
Libby
L
Palmer
Teresa
T
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