Evidence map›Paper›PMID 39741317›Full record

Observational studyBMC medicine2024

Assessment of the efficacy of palliative sedation in advanced cancer patients by evaluating discomfort levels: a prospective, international, multicenter observational study.

Maaike Rijpstra, Kris Vissers, Alazne Belar, Michael Van der Elst, Séverine Marie Surges, Claudio Adile, Rocío Rojí, Yasmine Grassi, Ewald Bronkhorst, Sebastiano Mercadante and 5 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04719702 (Palliative Sedation Across European Settings), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT04719702 completednot on this map

Palliative Sedation Across European Settings: a Prospective Observational Multicentre Study

TypeobservationalSponsorRadboud University Medical CenterRan2021 to 2023Enrolled80ConditionsPalliative Sedation
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Maaike RijpstraDepartment of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Geert Grooteplein 10, Nijmegen, 6500HB, the Netherlands. Maaike.vanderLee-Rijpstra@radboudumc.nl.ORCID 0000-0002-8747-3833
Kris VissersDepartment of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.ORCID 0000-0002-2919-6356
Alazne BelarIdISNA-Instituto de Investigación Sanitaria de Navarra, Palliative Medicine, Pamplona, Spain.ORCID 0000-0002-4831-5218
Michael Van der ElstDepartment of Oncology, Laboratory of Experimental Radiotherapy, Hospital and Catholic University Leuven, Louvain, Belgium.ORCID 0000-0001-9381-7287
Séverine Marie SurgesDepartment of Palliative Medicine, University Hospital Bonn, Bonn, Germany.ORCID 0000-0001-6991-1767
Claudio AdileMain Regional Center of Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, Italy.ORCID 0000-0002-0664-3520
Rocío RojíIdISNA-Instituto de Investigación Sanitaria de Navarra, Palliative Medicine, Pamplona, Spain.ORCID 0000-0002-4444-1743
Yasmine GrassiMain Regional Center of Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, Italy.ORCID 0000-0002-2060-0420
Ewald BronkhorstDepartment for Health Evidence, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.ORCID 0000-0003-0953-8053
Sebastiano MercadanteMain Regional Center of Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, Italy.ORCID 0000-0001-9859-6487
Lukas RadbruchDepartment of Palliative Medicine, University Hospital Bonn, Bonn, Germany.ORCID 0000-0001-9526-396X
Johan MentenDepartment of Oncology, Laboratory of Experimental Radiotherapy, Hospital and Catholic University Leuven, Louvain, Belgium.ORCID 0000-0003-2805-1953
Carlos CentenoIdISNA-Instituto de Investigación Sanitaria de Navarra, Palliative Medicine, Pamplona, Spain.ORCID 0000-0003-3395-7039
Evelien KuipDepartment of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.ORCID 0000-0002-9114-643X
Jeroen HasselaarDepartment of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Geert Grooteplein 10, Nijmegen, 6500HB, the Netherlands.ORCID 0000-0002-8880-2029

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPalliative sedation involves the intentional proportional lowering of the level of consciousness in patients with life-limiting disease who are experiencing refractory suffering. The efficacy of palliative sedation needs to be monitored to ensure patient comfort. The aim of this study was to evaluate the efficacy using discomfort levels combined with sedation/agitation levels.

methodsIn this prospective observational study, adult patients with advanced malignancies were recruited from hospice units, palliative care units, and hospital wards in five European countries. Health care professionals used proxy observations of discomfort levels (Discomfort Scale-Dementia of Alzheimer Type, range 0-27) and sedation/agitation levels (Richmond Agitation-Sedation Scale modified for palliative care inpatients), range - 5 to + 4) to evaluate the efficacy of palliative sedation.

resultsIn 78 participants, discomfort levels were monitored during palliative sedation. The mean discomfort score before start was 9.4 points (95% CI 8.3-10.5), which showed a significant decrease of 6.0 points (95% CI 4.8-7.1) after start of sedation for the total sedation period. In the multivariable analysis, no significant factors influencing baseline discomfort levels were identified. The discomfort and depth of sedation scores were found to be positively correlated, with an r of 0.72 (95% CI 0.61-0.82). The internal consistency of the discomfort scale was good (0.83), but the "Noisy breathing" item was less informative of the total discomfort score.

conclusionsThe efficacy of palliative sedation can be evaluated by measuring discomfort levels combined with sedation/agitation levels. The measurement of discomfort levels might provide a more specific and detailed evaluation of adequate sedation.

trial registrationThis study is registered at ClinicalTrials.gov since January 22, 2021, registration number: NCT04719702.

Indexed as

Hypnotics and SedativesInternationalityNeoplasmsPalliative CareAdultAgedAged, 80 and overEuropeFemaleHumansMaleMiddle AgedNeoplasm StagingProspective StudiesHypnotics and SedativesAdvanced cancerEnd-of-life careMonitoringObservational studyPalliative sedation

Identifiers

PMID39741317
PMCPMC11689561

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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.