title: Patients with End-stage Interstitial Lung Disease may have More Problems with Dyspnea than End-stage Lung Cancer Patients.
abstract: BACKGROUND
  Patients with end-stage interstitial  lung disease (ILD) do not appear to receive adequate palliative care despite apparent suffering before death. The aim of this study was to evaluate their signs, symptoms, and treatment received before death.
  
  
  METHODS
  Patients with ILD and lung cancer (LC) who were hospitalized and died in our hospital were enrolled retrospectively. Signs and symptoms and treatments at 7 days, 3 days, and 1 day before death were evaluated and compared between the two groups of patients.
  
  
  RESULTS
  A total of 23 patients with ILD and 59 patients with LC group were eligible for participation. Significantly more LC patients had loss of consciousness than ILD patients on 7 days (ILD: LC = 1 [5.6%]:24 [41%], P = 0.013), 3 days (1 [5.6%]:33 [56%], P < 0.001). Significantly more ILD patients had dyspnea than LC patients on 3 days (16 [89%]:38 [64%], P = 0.047) 1 day before death (21 [91%]:33 [56%], P = 0.001). On 1 day before death, significantly more LC patients received morphine than ILD patients (2 [8.7%]: 14 [24%], P = 0.015). More ILD patients received sedation (11 [48%]: 11 [19%], P = 0.007).
  
  
  CONCLUSIONS
  End-stage ILD patients may experience dyspnea more frequently than terminal LC patients, and they need sedation. Morphine should be administered to ILD patients who have dyspnea. Additional prospective studies are needed.
authors: Department of Respiratory Medicine, Komatsu Municipal Hospital, Ho-60, Mukaimoto-ori-machi, Komatsu 923-8560, Japan.
authors: Ryo
authors: R
authors: Matsunuma
authors: Department of Respiratory Medicine, The University of Kanazawa, Ishikawa 920-0293, Japan.
authors: Hazuki
authors: H
authors: Takato
authors: Department of Respiratory Medicine, Komatsu Municipal Hospital, Ho-60, Mukaimoto-ori-machi, Komatsu 923-8560, Japan.
authors: Yoshihiro
authors: Y
authors: Takeda
authors: Department of Respiratory Medicine, The University of Kanazawa, Ishikawa 920-0293, Japan.
authors: Satoshi
authors: S
authors: Watanabe
authors: Department of Respiratory Medicine, Japan Community Health Care Organization Kanazawa Hospital, Ha-15 Oki-machi, Kanazawa 920-8610, Japan.
authors: Yuko
authors: Y
authors: Waseda
authors: Department of Surgery, Komatsu Municipal Hospital, Ho-60, Mukaimoto-ori-machi, Komatsu 923-8560, Japan.
authors: Shinya
authors: S
authors: Murakami
authors: Department of Surgery, Komatsu Municipal Hospital, Ho-60, Mukaimoto-ori-machi, Komatsu 923-8560, Japan.
authors: Yukimitsu
authors: Y
authors: Kawaura
authors: Department of Respiratory Medicine, The University of Kanazawa, Ishikawa 920-0293, Japan.
authors: Kazuo
authors: K
authors: Kasahara
keywords: Dyspnea; Interstitial lung disease; Morphine; Palliative care