Evidence map›Paper›PMID 39931840›Full record

Observational studyCancer medicine2025

Pharmacological Strategies for Providing Patients With Delirium Relief From Terminal Dyspnea: A Secondary Data Analysis.

Takaaki Hasegawa, Masanori Mori, Takashi Yamaguchi, Kengo Imai, Yoshinobu Matsuda, Isseki Maeda, Yutaka Hatano, Naosuke Yokomichi, Jun Hamano, Tatsuya Morita and 1 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Cancer medicine, 2025. 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

11 authors.

Takaaki HasegawaCenter for Psycho-Oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan.ORCID https://orcid.org/0000-0001-7894-4528
Masanori MoriPalliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan.ORCID https://orcid.org/0000-0002-5489-9395
Takashi YamaguchiDepartment of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.ORCID https://orcid.org/0000-0003-3060-0245
Kengo ImaiSeirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan.ORCID https://orcid.org/0009-0003-6962-1518
Yoshinobu MatsudaDepartment of Psychosomatic Internal Medicine, NHO Kinki Chuo Chest Medical Center, Sakai, Japan.ORCID https://orcid.org/0000-0001-5092-9377
Isseki MaedaDepartment of Palliative Care, Senri-Chuo Hospital, Toyonaka, Japan.ORCID https://orcid.org/0000-0002-0018-3359
Yutaka HatanoDepartment of Palliative Care, Daini Kyoritsu Hospital, Kawanishi, Japan.ORCID https://orcid.org/0000-0002-9797-3487
Naosuke YokomichiPalliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan.ORCID https://orcid.org/0000-0003-0863-1184
Jun HamanoDepartment of Palliative and Supportive Care, University of Tsukuba, Tsukuba, Japan.ORCID https://orcid.org/0000-0003-0304-9881
Tatsuya MoritaPalliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan.ORCID https://orcid.org/0000-0002-7257-7429
East Asian Collaborative Cross‐Cultural Study to Elucidate the Dying Process (EASED) investigators

Funding

Aichi Cancer Research FoundationJapan Hospice Palliative Care FoundationJapan Society for the Promotion of Science 23K16438
6 · The paper itself

Abstract

introductionSystemic opioids are recommended as a pharmacological treatment for dyspnea, and antipsychotics are widely used for delirium. Because little is known about optimal palliative pharmacological strategies for dyspnea in patients with delirium, this study explored the symptom course in such cases, including the use of opioids and antipsychotics.

methodsThis was a secondary analysis of a multicenter prospective and observational study. We consecutively enrolled adult patients with advanced cancer at palliative care units in Japan. The eligibility criteria for their participation were a dyspnea Integrated Palliative care Outcome Scale (IPOS) score ≥ 2 and the presence of delirium. We investigated pharmacological strategies, IPOS for dyspnea, and delirium symptoms using item 9 of the Memorial Delirium Assessment Scale.

resultsOf the 1896 patients, 141 were found eligible and were analyzed. Eighty-two (58%) patients had agitated delirium, and the median survival period was 4 days. Regarding pharmacological strategy, 31 (22%) received opioid initiation or dose escalation, whereas 92 (65%) used regular antipsychotics. Although mean dyspnea IPOS scores significantly decreased from Day 1 to Day 2 (0.44, 95% CI: 0.24-0.64), the proportion of responders (IPOS score ≤ 1) was 21% (30/141). In the agitated delirium group, the proportion of remaining agitation symptoms at Day 2 was 74% (61/82).

conclusionsThe combined distressing symptoms of dyspnea and delirium during the last days of life are likely to be refractory suffering, which shows a poor response to pharmacological interventions, including opioids and antipsychotics.

Indexed as

Analgesics, OpioidAntipsychotic AgentsDeliriumDyspneaNeoplasmsAdultAgedAged, 80 and overFemaleHumansJapanMaleMiddle AgedPalliative CareProspective StudiesSecondary Data AnalysisAnalgesics, OpioidAntipsychotic Agentsantipsychotic agentsdeliriumdyspneaneoplasmopioidpalliative care

Identifiers

PMID39931840
PMCPMC11811727

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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.