Shock Index and Decreased Level of Consciousness as Terminal Cancer Patients' Survival Time Predictors: A Retrospective Cohort Study

Sato, Ko; Yokoi, Hideto; Tsuneto, Satoru

doi:10.1016/j.jpainsymman.2015.09.012

Cited by 8 publications

(21 citation statements)

References 31 publications

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“…20,21 In a retrospective cohort study of patients with advanced cancer, the combination of SI ≥ 1.0 and a decreased level of consciousness was identified as a useful assessment tool for short-term survival times. 13 SI was demonstrated to be a sensitive indicator of left ventricular dysfunction, and a persistently high SI suggests an unstable hemodynamic state in critically ill patients. 25 An increase in SI at the onset of a markedly reduced oral intake in noncancer patients indicates an unstable hemodynamic state.…”

Section: Discussionmentioning

confidence: 99%

“…We also converted systolic blood pressure and pulse to SI. Based on previous studies, SI was classified into 3 categories.…”

Section: Methodsmentioning

confidence: 99%

“…Vital signs, which are routinely measured in daily practice, are also used to assess the prognosis of dying patients . The Shock Index (SI), defined as the ratio of heart rate to systolic blood pressure, has recently attracted attention for its relationship with short‐term survival times in terminal cancer patients . The development of prognostic tools using these objective and subjective data has enabled medical professionals to relatively accurately estimate the end of life and provide appropriate care for terminal cancer patients and their families …”

Section: Introductionmentioning

confidence: 99%

“…12 The Shock Index (SI), defined as the ratio of heart rate to systolic blood pressure, has recently attracted attention for its relationship with short-term survival times in terminal cancer patients. 13 The development of prognostic tools using these objective and subjective data has enabled medical professionals to relatively accurately estimate the end of life and provide appropriate care for terminal cancer patients and their families. [14][15][16] The final stage of life is also important for noncancer patients; however, few studies have investigated the symptoms and signs that suggest imminent death.…”

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confidence: 99%

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Survival time after marked reduction in oral intake in terminally ill noncancer patients: A retrospective study

Hosoi

Ozone

Hamano

2019

J of Gen and Family Med

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Background The prediction of short‐term survival is important for noncancer patients and their families. Although a markedly reduced oral intake by cancer patients suggests a poor prognosis, the survival times of noncancer patients after its onset remain unclear. We herein investigated the time from a marked reduction in oral intake to death in noncancer patients as well as factors associated with their subsequent survival. Methods We conducted a retrospective medical record review of noncancer patients who died in our hospital between April 2017 and April 2018. We recorded the day when oral intake markedly decreased and the date of death. We extracted data on age, gender, the Charlson Comorbidities Index, mean daily fluid volume, laboratory test results, and vital signs converted to the Shock Index (SI). We used Cox's proportional hazards models to assess relationships between these factors and survival times after the onset of a markedly reduced oral intake. Results We analyzed data from 44 noncancer patients. The median time from the onset of a markedly reduced oral intake to death was 16.5 days. Based on Cox's proportional hazards models, only SI ≧ 1.0 at the onset of a markedly reduced oral intake correlated with survival times (hazard ratio: 5.89, 95% confidence interval (CI): 1.71‐20.1, P = .005). Conclusion Noncancer patients died a median of 16.5 days after the onset of a markedly reduced oral intake, and SI ≧1.0 correlated with subsequent survival times. These results will provide novel insights into the prognosis of noncancer patients at the end of life.

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Section: Discussionmentioning

confidence: 99%

“…We also converted systolic blood pressure and pulse to SI. Based on previous studies, SI was classified into 3 categories.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Survival time after marked reduction in oral intake in terminally ill noncancer patients: A retrospective study

Hosoi

Ozone

Hamano

2019

J of Gen and Family Med

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“…Low oxygen saturation has been reported to be a risk factor for death in patients with advanced cancer [1][2][3][16][17][18]. Randomized controlled trials have shown that long-term oxygen for patients with chronic obstructive pulmonary disease with severe hypoxemia resulted in reduced mortality [19,20].…”

Section: Introductionmentioning

confidence: 99%

Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study

Igarashi¹,

Fukushi²,

Nago³

2020

BMC Palliat Care

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Background: The role of oxygen therapy in end-of-life care for patients with advanced cancer is incompletely understood. We aimed to evaluate the association between oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care. Methods: We conducted a retrospective cohort study at a primary care practice in suburban Tokyo. Adult patients in home care with advanced cancer demonstrating first low oxygen saturation (less than 90%) detected in home visits were consecutively included in the study. Cox proportional hazards regression was used to investigate the effect of oxygen use on overall survival and survival at home, adjusted for systolic blood pressure, decreased level of consciousness, dyspnea, oral intake, performance status, and cardiopulmonary comorbidity. Results: Of 433 identified patients with advanced cancer, we enrolled 137 patients (oxygen use, n = 35; no oxygen use, n = 102) who developed low oxygen saturation. In multivariable analysis, the adjusted hazard ratio (HR) of oxygen use was 0.68 (95% confidence interval 0.39-1.17) for death and 0.70 (0.38-1.27) for death at home. In patients with dyspnea, the HR was 0.35 (0.13-0.89) for death and 0.33 (0.11-0.96) for death at home; without dyspnea, it was 1.03 (0.49-2.17) for death and 0.84 (0.36-1.96) for death at home. Conclusions: Oxygen use was not significantly associated with survival in patients with advanced cancer and low oxygen saturation, after adjusting for potential confounders. It may not be necessary to use oxygen for prolongation of survival in such patients, particularly in those without dyspnea.

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Factors Associated with the Effectiveness of Intravenous Administration of Chlorpromazine for Delirium in Patients with Terminal Cancer

Hasuo

Kanbara

Fujii

et al. 2018

Journal of Palliative Medicine

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Shock Index and Decreased Level of Consciousness as Terminal Cancer Patients' Survival Time Predictors: A Retrospective Cohort Study

Abstract: An SI ≥ 1.0 along with DLOC is a highly reliable tool for predicting short-term survival time in terminal cancer patients.

Cited by 8 publications

References 31 publications

Survival time after marked reduction in oral intake in terminally ill noncancer patients: A retrospective study

Survival time after marked reduction in oral intake in terminally ill noncancer patients: A retrospective study

Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study

Factors Associated with the Effectiveness of Intravenous Administration of Chlorpromazine for Delirium in Patients with Terminal Cancer

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