title: Doctor, how long?
abstract: This study aimed to quantify the average survival time of cancer patients once terminal sedation was started until death and identify potential variables that may influence their survival time on sedation. This is a retrospective cohort analysis of all consecutive terminal cancer patients who died after starting terminal sedation at public tertiary Brazilian Hospital. A total of 532 cancer patients died in Hospital Estadual Mário Covas during this period and 181 out of them who received terminal sedation were included in this analysis. The median survival was 27 h. By multivariate analysis, increase in the dose of sedative drug during sedation (odds ratio 1.576, 95% CI 1.113-2.232), use of opioids alone for sedation (odds ratio 1.438, 95% CI 1.046-1.977) and dyspnoea as cause of sedation (odds ratio 1.564 95% CI 1.045-2.341) were independent risk factors for a shorter survival time after starting terminal sedation. Sedated, terminal cancer patients usually live about 1 day. We identified risk factors for a shorter sedation period. This study is limited by its retrospective design and by the frequent use of opioids as the main sedative medications. Prospective studies must be carried out in order to validate these data.
authors.affiliation: ABC Foundation School of Medicine, Santo Andre, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Da Costa Miranda
authors.forename: A B
authors.initials: AB
authors.lastname: De Souza Fede
authors.forename: F D
authors.initials: FD
authors.lastname: Martins
authors.forename: N P
authors.initials: NP
authors.lastname: De Magalhães
authors.forename: H
authors.initials: H
authors.lastname: De Lazzari Schaffhausser
authors.forename: R P
authors.initials: RP
authors.lastname: Riechelmann
authors.forename: A D
authors.initials: AD
authors.lastname: Giglio
mesh_terms: D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D013727:Terminal Care; D013997:Time Factors
chemical_list: D006993:Hypnotics and Sedatives