ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2012
Prospective observational Italian study on palliative sedation in two hospice settings: differences in casemixes and clinical care.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Identification and evaluation of observational measures for the assessment and/or monitoring of level of consciousness in adult palliative care patients: A systematic review for I-CAN-CARE.Palliative medicine · 2020Pooled it
- [Palliative sedation : Development and consensus of a German language documentation template].Der Anaesthesist · 2018Guideline
- Palliative pharmacological sedation for terminally ill adults.The Cochrane database of systematic reviews · 2015Pooled it
- Clinical profile and challenges of midazolam-based palliative sedation for terminal cancer patients: A retrospective observational study from a tertiary medical center in mainland China.Palliative care and social practice · 2026Article
- Attitudes and practices of hospice physicians regarding palliative sedation: a cross-sectional descriptive study.BMJ open · 2025Article
- Frequency and predictors of palliative sedation among patients with cancer who died in a specialist inpatient palliative care unit: a retrospective study.BMC palliative care · 2025Article
- Use of sedative drugs in specialist palliative care (iSedPall): a multi-modal intervention pilot study protocol.Pilot and feasibility studies · 2025Article
- Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall).BMC palliative care · 2023Article
- Association of the RASS Score with Intensity of Symptoms, Discomfort, and Communication Capacity in Terminally Ill Cancer Patients Receiving Palliative Sedation: Is RASS an Appropriate Outcome Measure?Palliative medicine reports · 2022Article
- Article
- How to measure the effects and potential adverse events of palliative sedation? An integrative review.Palliative medicine · 2021Review
- Midazolam sedation in palliative medicine: retrospective study in a French center for cancer control.BMC palliative care · 2020Article
- Palliative sedation: beliefs and decision-making among Spanish palliative care physicians.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- Palliative Sedation for the Terminally Ill Patient.CNS drugs · 2018Review
- Palliative sedation in advanced cancer patients hospitalized in a specialized palliative care unit.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Article
- Care provided and care setting transitions in the last three months of life of cancer patients: a nationwide monitoring study in four European countries.BMC cancer · 2014Article
- The EAPC framework on palliative sedation and clinical practice--a questionnaire-based survey in Germany.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2014Article
- The Richmond Agitation-Sedation Scale modified for palliative care inpatients (RASS-PAL): a pilot study exploring validity and feasibility in clinical practice.BMC palliative care · 2014Article
- Palliative sedation.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePalliative sedation (PS) has been defined as the use of sedative medications to relieve intolerable suffering from refractory symptoms by a reduction in patient consciousness. It is sometimes necessary in end-of-life care when patients present refractory symptoms. We investigated PS for refractory symptoms in different hospice casemixes in order to (1) assess clinical decision-making, (2) monitor the practice of PS, and (3) examine the impact of PS on survival.
methodsThis observational longitudinal cohort study was conducted over a period of 9 months on 327 patients consecutively admitted to two 11-bed Italian hospices (A and B) with different casemixes in terms of median patient age (hospice A, 66 years vs. hospice B, 73 years; P = 0.005), mean duration of hospice stay (hospice A, 13.5 days vs. hospice B, 18.3 days; P = 0.005), and death rate (hospice A, 57.2% vs. hospice B, 89.9%; P < 0.0001). PS was monitored using the Richmond Agitation-Sedation Scale (RASS). Sedated patients constituted 22% of the total admissions and 31.9% of deceased patients, which did not prove to be significantly different in the two hospices after adjustment for casemix.
resultsPatient involvement in clinical decision-making about sedation was significantly higher in hospice B (59.3% vs. 24.4%; P = 0.007). Family involvement was 100% in both hospices. The maximum level of sedation (RASS, -5) was necessary in only 58.3% of sedated patients. Average duration of sedation was similar in the two hospices (32.2 h [range, 2.5-253.0]). Overall survival in sedated and nonsedated patients was superimposable, with a trend in favor of sedated patients.
conclusionsPS represents a highly reproducible clinical intervention with its own indications, assessment methodologies, procedures, and results. It does not have a detrimental effect on survival.
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