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ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2022

The quality of palliative sedation in end-stage disease: audit from a department of oncology and haematology.

Saviola Alessia, Schipilliti Francesca Matilde, Isca Chrystel, Salati Massimiliano, Dini Daniele, Fiorani Claudia, Postiglione Raffaella, Cantile Flavia, Ferrara Leonardo, Carboni Chiara and 4 more

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Saviola AlessiaOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy. saviola.alessia@aou.mo.it.
Schipilliti Francesca MatildeOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Isca ChrystelOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Salati MassimilianoOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Dini DanielePalliative Care Unit, Department of Oncology and Haematology, University Hospital of Modena and Reggio Emilia, Modena, Italy.
Fiorani ClaudiaOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Postiglione RaffaellaOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Cantile FlaviaOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Ferrara LeonardoOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Carboni ChiaraOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Potenza LeonardoHematology Unit, Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy.
Dominici MassimoOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
Luppi MarioHematology Unit, Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy.
Longo GiuseppeOncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePalliative sedation (PS) plays a critical role to give suffering relief from refractory symptoms at the end of life. Our audit aimed to assess and improve quality of PS at the Department of Oncology and Hematology of University Hospital of Modena, to verify the adherence to international guidelines, the cooperation among members of care team, focusing with attention on family's perception of this delicate situation.

methodsFrom December 2016 to June 2019, data of patients undergoing PS in the Department were collected by an electronic folder tool, "Sedation Tool" (ST), that recorded clinical and PS informations, D-PaP, Rudkin score, and family's perception.

resultsIn total, 245 patients were enrolled. Eighty-two percent had a Karnofsky Performance Status 10-20%. The most common cancer types were lung and gastro-intestinal carcinomas (27% and 21% respectively). Refractory symptoms observed were confusion and agitation (76%), dyspnea (39%), pain (15%), delirium (10%), and psychological distress (5%). Midazolam was the drug of choice for PS. Most of patients had Rudkin score 5 after 24 h and 33% had terminal event within a period of 24 h from the beginning of PS. During PS, most of patient's relatives reported peacefulness (65%), agitation/impatience in 6% of cases, and concern for suffering (16%).

conclusionPS is used in case of worsening general conditions at the end-stage disease to relieve refractory symptoms with dignity. The ST can become a simple instrument to evaluate and improve PS quality, providing more attention on the impact of PS on relatives to then possibly develop new supportive procedures for patients and their families.

Indexed as

Deep SedationHematologyNeoplasmsTerminal CareHumansHypnotics and SedativesMedical OncologyMidazolamPalliative CareProcedural SedationHypnotics and SedativesMidazolamD-PaP scoreEnd-stage diseaseMidazolamPalliative sedationRefractory symptomsRudkin score

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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.