Palliative Sedation in Patients Hospitalized in Internal Medicine Departments.
Por:
Díez-Manglano J, Isasi de Isasmendi Pérez S, García Fenoll R, Sánchez LÁ, Formiga F, Giner Galvañ V, Dueñas C, Roca B, Estrada Díaz C and Casariego Vales E
Publicada:
1 feb 2020
Ahead of Print:
23 oct 2019
Resumen:
CONTEXT: Palliative sedation is used to relieve end-of-life refractory symptoms. OBJECTIVE: The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments. METHODS: An observational, cross-sectional, retrospective, and multicenter clinical audit study was conducted in 145 hospitals in Spain and Argentina. Each hospital included the first 10 patients who died in the internal medicine department, starting on December 1, 2015. RESULTS: We included 1447 patients, and palliative sedation was administered to 701 patients (48.4%). Having a terminal illness (odds ratio [OR] 2.469, 95% CI 1.971-3.093, P < 0.001) and the length of hospital stay (OR 1.011, 95% CI 1.002-1.021, P = 0.017) were independently associated with the use of palliative sedation. Consent was granted by the families of 582 (83%) patients. The most common refractory symptom was dyspnea, and the most commonly used drugs for sedation were midazolam (77%) and morphine (89.7%). An induction dose was administered in 25.7% of the patients. Rescue doses were scheduled for 70% of the patients, and hydration was maintained in 49.5%. Pain was more common in patients with cancer, whereas dyspnea was more common in those without cancer. Rescue doses were used more often for the patients with cancer (77.8% vs. 67.7%, P = 0.015). Monitoring the palliative sedation with a scale was more frequent in the patients with cancer (23.7% vs. 14.3%, P = 0.008). CONCLUSIONS: Palliative sedation is used more often for terminal patients. There are differences in the administration of palliative sedation between patients with and without cancer.
Filiaciones:
Díez-Manglano J:
Internal Medicine Department, Hospital Royo Villanova, Zaragoza, Spain
Isasi de Isasmendi Pérez S:
Internal Medicine Department, Hospital Royo Villanova, Zaragoza, Spain
García Fenoll R:
Internal Medicine Department, Hospital Miguel Servet, Zaragoza, Spain
Sánchez LÁ:
Internal Medicine Department, Hospital Clínico Universitario, Valladolid, Spain
Formiga F:
Internal Medicine Department, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Spain
:
Internal Medicine Department, Hospital Mare de Deu dels Lliris, Alcoy, Spain
Dueñas C:
Internal Medicine Department, Hospital Clínico Universitario, Valladolid, Spain
:
Internal Medicine Department, Hospital General Universitario, Castellón, Spain
Estrada Díaz C:
Internal Medicine Department, Hospital Universitario Mutua de Tarrassa, Tarrassa, Spain
Casariego Vales E:
Internal Medicine Department, Hospital Lucus Augusti, Lugo, Spain
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