title: [Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care].
abstract: BACKGROUND
  Pain is a common symptom experienced by cancer patients, especially in those with advanced disease. Our aim was to describe pain intensity in advanced cancer patients, referred to the palliative care unit, the factors underlying moderate to severe pain and its prognostic values.
  
  
  METHODS
  This was a prospective observational study. All patients with mestastatic solid tumors and with no specific oncologic treatment were included. Pain intensity was accessed using the pain scale from Edmonton Symptom Assessment Scale, rated from 0 to 10 on a numerical scale, where zero = no pain and 10 = worst possible pain.
  
  
  RESULTS
  Between October 2012 and June 2015, a total of 301 patients participated in the study. The median age was 69 years, (37 - 94); most of the patients were men (57%) and 64.8% had a performance status of 3/4. About 42% reported pain severity ≥ 4 and 74% were medicated with opioids. Multivariate analysis indicated a correlation between performance status and reported pain (OR: 1.7; IC 95%: 1.0 - 2.7; p = 0.045). Median overall survival was 37 days (IC 95%: 28 - 46). Patients reporting moderate to severe pain (pain severity ≥ 4) had a median survival of 29 days (IC 95%: 21 - 37), comparing with those who had no or moderate pain with median survival of 49 days (IC 95%: 35 - 63) (p = 0.022).
  
  
  CONCLUSIONS
  The performance status was associated with more intense pain. The performance status, hospitalization, intra-abdominal metastization and opioid analgesia were associated with shorter time to death in advanced cancer patients referred to palliative care.
  
  
  CONCLUSIONS
  Cancer pain continues to be a major clinical problem in advanced cancer patients.
authors.affiliation: Serviço de Oncologia Médica. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Barata
authors.affiliation: Departamento de Ciências Biomédicas e Medicina. Universidade do Algarve. Faro. Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Santos
authors.affiliation: Unidade de Dor Crónica. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
authors.forename: Graça
authors.initials: G
authors.lastname: Mesquita
authors.affiliation: Cuidados Paliativos. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
authors.forename: Alice
authors.initials: A
authors.lastname: Cardoso
authors.affiliation: Serviço de Oncologia Médica. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
authors.forename: Maria Paula
authors.initials: MP
authors.lastname: Custódio
authors.affiliation: Gabinete de Análise Epidemiológica e Estatística. Centro de Investigação. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Alves
authors.affiliation: Gabinete de Análise Epidemiológica e Estatística. Centro de Investigação. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
authors.forename: Ana Luísa
authors.initials: AL
authors.lastname: Papoila
authors.affiliation: Centro de Bioética. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Barbosa
authors.affiliation: Cuidados Paliativos. Institutos de Investigação de Bruyere e Ottawa. Universidade de Ottawa. Ottawa. Canadá.
authors.forename: Peter
authors.initials: P
authors.lastname: Lawlor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010146:Pain; D010147:Pain Measurement; D010166:Palliative Care; D011446:Prospective Studies
keywords: Cuidados Paliativos; Medição da Dor; Neoplasias.