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KMID : 0978920100110020143
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Korean Journal of Clinical Geriatrics
2010 Volume.11 No. 2 p.143 ~ p.153
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Symptoms and Quality of Life According to Length of Survival in Hospice Cancer Patients
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Kim Kun-Young
Choi Youn-Seon
Kim Dae-Kyun
Suh Sang-Yeon
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Abstract
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Background: Cancer had become the 1st leading cause of death in Korea since 1983. There were roughly 65,000 cancer deaths per year in 2006. Survival prediction is difficult even among experienced palliative care doctors. Appropriate symptom control and QoL are important in end of life.
Methods: Eleven physicians of the Korean Palliative Medicine Research Group performed this study. We followed terminal cancer inpatients until their death between November 2006 and December 2007.A total 137 patients who completed a Korean version of MDASI before their death from 6 teaching hospitals were included in this cohort study. Basic data was obtained at the time of hospital admission. The subjects were divided into 3 groups according to length of survival. The first group A consists of patients who lived less than 14 days, group B patients lived between 15 and 34 days. Lastly, group C patients lived more than 35 days. Then symptom prevalence and severity, and quality of life were compared.
Results: 46.7% were male. Mean age was 63.9 years old. The mean survival time was around 39days. Survival duration was decreased by a lower ECOG score. There was no significant differences in survival duration according to age, type of primary cancer, or regular opioid use. Dry mouth, lack of appetite, fatigue were the most prevalent symptoms. General activity and mood were the most prevalent QoL impairments. There was no significant difference in prevalence by sex except sleep
disturbance in which there was a higher frequency in females. There were seven items in the symptom category and one item in the QoL interference category where prevalence increased as length of
survival was shortened with statistical significance. Dry mouth, lack of appetite, and fatigue were the most severe symptoms. Work, general activity, and walking were the most severe QoL impairments.11 symptoms except remembering & numbness of tingling and all 6 QoL impairments were worsened by decreased survival duration. No significant difference in severity of both symptoms and QOL impairment was present by sex except three items.
Conclusion: It is evident that prevalence and severity of symptoms was high in Korean terminal cancer patients. More active symptom management is needed.
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KEYWORD
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Quality of life, Length of survival, Hospice, Cancer
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