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KMID : 0856920080110020099
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Journal of Hospice and Palliative Care
2008 Volume.11 No. 2 p.99 ~ p.105
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Clinical Change of Terminally Ill Cancer Patients at the End-of-life Time
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Koh Su-JIN
Yoo Yang-Sook
Park Hyea-Ja
Lee Kyung-Sik
Hong Young-Sun
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Abstract
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Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients.
Methods: We enrolled the terminal cancer patients from Kangnam St. Mary’s Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use.
Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death.
Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.
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KEYWORD
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Death prognosis, Clinical prognostic factor, Terminal cancer
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