Effect of parenteral hydration therapy based on the Japanese national clinical guideline on quality of life, discomfort, and symptom intensity in patients with advanced cancer.
BACKGROUND
Although an evidence-based clinical guideline for parenteral hydration therapy was established in Japan, the efficacy of the guideline has not been assessed.


OBJECTIVE
Our purpose was to explore the effect of parenteral hydration therapy based on this clinical guideline on quality of life (QoL), discomfort, symptoms, and fluid retention signs in patients with advanced cancer.


METHODS
This multicenter, prospective, observational study included 161 patients with advanced abdominal cancer who received guideline-based hydration therapy. We evaluated the longitudinal changes of the global QoL (Item 30 of European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30); the Discomfort Scale; the intensity of seven physical symptoms; and the severity of fluid retention signs. We also evaluated patient satisfaction and the feeling of benefit from hydration one week after the study commenced, and bronchial secretions, hyperactive delirium, communication capacity, and agitation 48 hours before a patient's death.


RESULTS
The global QoL, the Discomfort Scale, and the intensities of all physical symptoms, except for vomiting and drowsiness, were stable throughout the study period. More than 80% of patients maintained all fluid retention signs. Patient global satisfaction was 76.4 (0-100) and feeling of benefit was 5.43 (range 0-7).


CONCLUSIONS
Guideline-based parenteral hydration therapy contributed to maintaining global QoL and provided satisfaction and a feeling of benefit without increasing discomfort and worsening symptoms and fluid retention signs in patients with advanced cancer.
Department of General Internal Medicine and Palliative Care Team, Teine Keijinkai Hospital, Sapporo, Japan. ikagoro@pop06.odn.ne.jp
Takashi
T
Yamaguchi
Tatsuya
T
Morita
Takuya
T
Shinjo
Satoshi
S
Inoue
Chizuko
C
Takigawa
Etsuko
E
Aruga
Kazuhiko
K
Tani
Takashi
T
Hara
Yoichiro
Y
Tamura
Akihiko
A
Suga
Seiji
S
Adachi
Hideki
H
Katayama
Iwao
I
Osaka
Yoshiyuki
Y
Saito
Nobuhisa
N
Nakajima
Takashi
T
Higashiguchi
Tatsuhiko
T
Hayashi
Takeshi
T
Okabe
Hiroyuki
H
Kohara
Tomohiro
T
Tamaki
Yoshikazu
Y
Chinone
Hideki
H
Aragane
Yoshiaki
Y
Kanai
Natsuki
N
Tokura
Takuhiro
T
Yamaguchi
Takashi
T
Asada
Yosuke
Y
Uchitomi
D000368:Aged; D015897:Comorbidity; D005260:Female; D005440:Fluid Therapy / Q000401:mortality / Q000592:standards; D006801:Humans; D007564:Japan; D008297:Male; D009369:Neoplasms / Q000401:mortality* / Q000451:nursing*; D010146:Pain / Q000401:mortality / Q000517:prevention & control; D010288:Parenteral Nutrition / Q000401:mortality / Q000592:standards; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control; D016019:Survival Analysis; D015996:Survival Rate; D013727:Terminal Care / Q000592:standards / Q000706:statistics & numerical data*; D016896:Treatment Outcome