title: [Determining factors in the sedation of geriatric and oncology patients treated at home].
abstract: BACKGROUND
  Sedation, used as a therapeutic measure in the field of Palliative Care, continues to present difficulties for many professionals in its management and indications. Is varied existing literature in this regard, often exclusive cancer patients. Our objective is to analyse the characteristics of patients attended by a Home Care Support Team who required sedation compared to non-sedated patients, for possible determining factors for its use that could help in decision-making.
  
  
  METHODS
  A prospective analytical study conducted in Barbastro (Huesca) from September 2007 to February 2011. The study population are patients referred to the Home Care Support Team of Barbastro.
  
  
  METHODS
  Age, sex, medical history, symptoms, previous and current Barthel, Karnofsky, primary caregiver, previous drugs, drugs after intervention, sedation yes/no.
  
  
  RESULTS
  Required sedation 16.6% (n=106) of the cases (N=638). Sedated patients were younger, with no differences in sex, and the large majority (83%) were oncology patients. The presence of metastases showed no differences in need for sedation. Sedated patients have an increased functional impairment, determined by Barthel index decreased and a worse Karnofsky. Sedated patients showed increased frequency of uncontrolled symptoms, except psychomotor agitation, a fact determined by the medications used pre- and post-intervention.
  
  
  CONCLUSIONS
  The presence of neoplastic disease, marked with existence of functional decline, and uncontrolled clinical need for certain medications to control symptoms may determine the need for sedation at the end of the process, above other factors such as patient comorbidity.
authors.affiliation: Equipo de Soporte Hospitalario de Cuidados Paliativos, Servicio de Geriatría, Hospital de Barbastro, Barbastro, Huesca, España; Departamento de Anatomía e Histología Humanas, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España. Electronic address: alzamur@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Zamora-Mur
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España.
authors.forename: R
authors.initials: R
authors.lastname: García-Foncillas
authors.affiliation: Servicio de Especialidades Médicas, Hospital de Barbastro, Barbastro, Huesca, España.
authors.forename: A
authors.initials: A
authors.lastname: Zamora-Catevilla
authors.affiliation: Equipo de Soporte Hospitalario de Cuidados Paliativos, Hospital Arnau de Villanova, Lérida, España.
authors.forename: M
authors.initials: M
authors.lastname: Nabal-Vicuña
authors.affiliation: Servicio de Oncología Médica, Hospital de Barbastro, Barbastro, Huesca, España.
authors.forename: V
authors.initials: V
authors.lastname: Calderero-Aragón
authors.affiliation: Departamento de Anatomía e Histología Humanas, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España.
authors.forename: F
authors.initials: F
authors.lastname: Lostalé-Latorre
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003657:Decision Making; D005260:Female; D006699:Home Care Services; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D017567:Karnofsky Performance Status; D008297:Male; D009369:Neoplasms / Q000473:pathology / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000453:epidemiology; D013030:Spain
chemical_list: D006993:Hypnotics and Sedatives
keywords: Atención domiciliaria; Cuidados paliativos; Home care; Palliative care; Palliative sedation; Sedación paliativa