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Palliative sedation in patients with advanced cancer in a specialized unit in a middle-income country: A retrospective cohort study

Published online by Cambridge University Press:  24 August 2021

Carolina Záu Serpa de Araujo Open the ORCID record for Carolina Záu Serpa de Araujo [Opens in a new window] ,
Laís Záu Serpa de Araújo Open the ORCID record for Laís Záu Serpa de Araújo [Opens in a new window]  and
Antonio Paulo Nassar Junior Open the ORCID record for Antonio Paulo Nassar Junior [Opens in a new window]
Carolina Záu Serpa de Araujo
Affiliation:
Palliative Care Unit, Santa Casa de Misericordia, Maceió, Brazil
Laís Záu Serpa de Araújo
Affiliation:
Discipline of Bioethics, Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil
Antonio Paulo Nassar Junior*
Affiliation:
A.C. Camargo Cancer Center, São Paulo, Brazil
*
Author for correspondence: Antonio Paulo Nassar Junior, Rua Professor Antonio Prudente, 211-6th floor, CEP 01509-010 São Paulo, Brazil. E-mail: paulo.nassar@accamargo.org.br
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Abstract

Objective

To describe the 5-year practice on palliative sedation in a specialized palliative care unit in a deprived region in Brazil, and to compare survival of patients with advanced cancer who were and were not sedated during their end-of-life care.

Method

Retrospective cohort study in a tertiary teaching hospital. We described the practice of palliative sedation and compared the survival time between patients who were and were not sedated in their last days of life.

Results

We included 906 patients who were admitted to the palliative care unit during the study period, of whom, 92 (10.2%) received palliative sedation. Patients who were sedated were younger, presented with higher rates of delirium, and reported more pain, suffering, and dyspnea than those who were not sedated. Median hospital survival of patients who received palliative sedation was 9.30 (CI 95%, 7.51–11.81) days and of patients who were not sedated was 8.2 (CI 95%, 7.3–9.0) days (P = 0.31). Adjusted for age and sex, palliative sedation was not significantly associated with hospital survival (hazard ratio = 0.93; CI 95%, 0.74–1.15).

Significance of results

Palliative sedation can be accomplished even in a deprived area. Delirium, dyspnea, and pain were more common in patients who were sedated. Median survival was not reduced in patients who were sedated.

Keywords

CancerCancer care facilitiesDeep sedationEnd-of-life carePalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 491 - 495
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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