Fonctions cognitives et vigilance des patients hospitalisés dans une unité de soins palliatifs : enquête un jour donné

Guirimand, Frédéric; Prémorel, Isabel de

doi:10.1016/j.medpal.2008.12.004

Cited by 1 publication

(1 citation statement)

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“…Our results thus suggest that it would be beneficial to implement a systematic scale for assessing dyspnea, beginning at admission, with systematic re‐evaluations during the patient's stay. However, self‐report scales, such as the Edmonton or the French‐validated MDASI scales, may not always be appropriate for use in patients in the terminal phase of illness, because 70% of these patients experience cognitive problems or a loss of vigilance in the last few days of life . Observation scales for dyspnea are therefore of particular importance for use in this population and their validation in French is urgently required .…”

Section: Discussionmentioning

confidence: 99%

Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer

et al. 2015

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Dyspnea is a symptom that severely affects the quality of life of terminally ill patients. Its frequency differs considerably between studies. We aimed to characterize the frequency of dyspnea in a palliative care hospital (PCH) and to identify factors predisposing to dyspnea, particularly during the very last days of life, as a function of the underlying disease. Episodes of dyspnea were identified by the computerized extraction of prospectively collected data from the reports of care assistants or from medical observations recorded in the medical files for all stays at our PCH during the last 6 years. There were 6455 hospital stays, 88% ending in the death of the patient; 13,282 episodes of dyspnea were recorded during 2608 hospital stays (40%). Dyspnea was more frequently observed in cases of cancer than in other conditions (RR = 1.30; 95% CI: 1.14–1.48). Pulmonary metastasis increased the risk of dyspnea from 37% to 51% (RR = 1.37; 95% CI: 1.29–1.46). Dyspnea frequency varied with the primary cancer site, from 24% (brain cancer) to 60% (esophageal cancer). The data for cancer patients staying for more than 6 days who subsequently died indicated that 8% of patients experienced dyspnea exclusively during the last 4 days of the life, independently of the site of the primary cancer. Dyspnea during the last few days of life requires systematic assessment. Exclusively terminal dyspnea should be distinguished from more precocious dyspnea, as the pathophysiological mechanisms and treatments of these two forms are probably different.

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Section: Discussionmentioning

confidence: 99%