Association between continuous deep sedation and survival time in terminally ill cancer patients
- Authors
- Park, So-Jung; Ahn, Hee Kyung; Ahn, Hong Yup; Han, Kyu-Tae; Hwang, In Cheol
- Issue Date
- May-2021
- Publisher
- SPRINGER
- Keywords
- Continuous deep sedation; Palliative sedation; Survival; Sedative; Palliative care; Hospice
- Citation
- SUPPORTIVE CARE IN CANCER, v.29, no.1, pp.525 - 531
- Journal Title
- SUPPORTIVE CARE IN CANCER
- Volume
- 29
- Number
- 1
- Start Page
- 525
- End Page
- 531
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/80004
- DOI
- 10.1007/s00520-020-05516-8
- ISSN
- 0941-4355
- Abstract
- Purpose Our study aimed to evaluate the association between CDS and survival time using the likelihood of receiving CDS to select a matched non-CDS group through an accurate measurement of survival time based on initiation of CDS. Methods A retrospective cohort study was performed using an electronic database to collect data regarding terminally ill cancer patients admitted to a specialized palliative care unit from January 2012 to December 2016. We first used a Cox proportional hazard model with receiving CDS as the outcome to identify individuals with the highest plausibility of receiving CDS among the non-CDS group (n = 663). We then performed a multiple regression analysis comparing the CDS group (n = 311) and weighted non-CDS group (n = 311), using initiation of CDS (actual for the CDS group; estimated for the non-CDS group) as the starting time-point for measuring survival time. Results Approximately 32% of participants received CDS. The most common indications were delirium or agitation (58.2%), intractable pain (28.9%), and dyspnea (10.6%). Final multiple regression analysis revealed that survival time was longer in the CDS group than in the non-CDS group (Exp(beta), 1.41; P < 0.001). Longer survival with CDS was more prominent in females, patients with renal dysfunction, and individuals with low C-reactive protein (CRP) or ferritin, compared with their counterpart subgroup. Conclusions CDS was not associated with shortened survival; instead, it was associated with longer survival in our terminally ill cancer patients. Further studies in other populations are required to confirm or refute these findings.
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