Observational studyJournal of pain and symptom management2015
Frequency and factors associated with unexpected death in an acute palliative care unit: expect the unexpected.
Observational study in Journal of pain and symptom management, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 36 citations in OpenAlex.
- "There's a lot of unknowns": a thematic analysis of the experiences of young adults with cancer who died during a psychosocial intervention trial.BMC palliative care · 2025Trial
- Recognising dying: Will artificial intelligence (AI) help improve clinical accuracy?Future healthcare journal · 2026Article
- Review
- Case report: Poor prognosis or poor prognostication?Palliative & supportive care · 2024Article
- Factors associated with good death of patients with advanced cancer: a prospective study in Japan.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Prognostication of the Last Days of Life.Cancer research and treatment · 2022Article
- Incidence and associated factors of sudden unexpected death in advanced cancer patients: A multicenter prospective cohort study.Cancer medicine · 2021Article
- Patient with respiratory distress, facial oedema and refractory hypokalaemia.BMJ case reports · 2021Article
- Acute palliative care unit-initiated interventions for advanced cancer patients at the end of life: prediction of impending death based on Glasgow Prognostic Score.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Dealing with prognostic uncertainty: the role of prognostic models and websites for patients with advanced cancer.Current opinion in supportive and palliative care · 2019Review
- Factors associated with discharge disposition on an acute palliative care unit.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Article
- Unexpected death in palliative care: what to expect when you are not expecting.Current opinion in supportive and palliative care · 2015Review
- Prognostication of Survival in Patients With Advanced Cancer: Predicting the Unpredictable?Cancer control : journal of the Moffitt Cancer Center · 2015Review
- Temporal, Probabilistic and Surprise Question Approaches of Clinician Predicted Survival in Advanced Hepatopancreaticobiliary Cancers: A Prospective Cohort Study.Indian journal of palliative careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
contextFew studies have examined the frequency of unexpected death and its associated factors in a palliative care setting.
objectivesTo determine the frequency of unexpected death in two acute palliative care units (APCUs); to compare the frequency of signs of impending death between expected and unexpected deaths; and to determine the predictors associated with unexpected death.
methodsIn this prospective, longitudinal, observational study, consecutive patients admitted to two APCUs were enrolled and physical signs of impending death were documented twice daily until discharge or death. Physicians were asked to complete a survey within 24 hours of APCU death. The death was considered unexpected if the physician answered "yes" to the question "Were you surprised by the timing of the death?"
resultsIn total, 193 of 203 after-death assessments (95%) were collected for analysis. Nineteen of 193 patients died unexpectedly (10%). Signs of impending death, including non-reactive pupils, inability to close eyelids, decreased response to verbal stimuli, drooping of nasolabial folds, peripheral cyanosis, pulselessness of the radial artery, and respiration with mandibular movement, were documented more frequently in expected deaths than unexpected deaths (P < 0.05). Longer disease duration was associated with unexpected death (33 months vs. 12 months, P = 0.009).
conclusionUnexpected death occurred in an unexpectedly high proportion of patients in the APCU setting and was associated with fewer signs of impending death. Our findings highlight the need for palliative care teams to be prepared for the unexpected.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.