Refractory symptoms observed were confusion and agitation (76%), dyspnea (39%), pain (15%), delirium (10%), and psychological distress (5%). The most common cancer types were lung and gastro-intestinal carcinomas (27% and 21% respectively). Eighty-two percent had a Karnofsky Performance Status 10–20%. Our audit aimed to assess and improve quality of PS at the Department of Oncology and Hematology of University Hospital of Modena, to verify the adherence to international guidelines, the cooperation among members of care team, focusing with attention on family’s perception of this delicate situation.Methodsįrom December 2016 to June 2019, data of patients undergoing PS in the Department were collected by an electronic folder tool, “Sedation Tool” (ST), that recorded clinical and PS informations, D-PaP, Rudkin score, and family’s perception.ResultsIn total, 245 patients were enrolled. PurposePalliative sedation (PS) plays a critical role to give suffering relief from refractory symptoms at the end of life. PST does not shorten life when used to relieve refractory symptoms and does not need the doctrine of double effect to justify its use from an ethical point of view. Median survival of arm A was 12 days, while that of arm B was 9 days (90% CI 8-10) (log rank = 0.95, P = 0.330) (unadjusted hazard ratio = 0.92, 90% CI 0.80-1.06). Mean and median duration of sedation was 4 (standard deviation 6.0) and 2 days (range 0-43), respectively. In total, 25.1% of patients admitted to the participating hospices received PST.

Of the 518 patients enrolled, 267 formed cohort A and 251 cohort B. Cohorts were matched for age class, gender, reason for hospice admission, and Karnofsky performance status. This multicenter, observational, prospective, nonrandomized population-based study evaluated overall survival in two cohorts of hospice patients, one submitted to palliative sedation (A) and the other managed as per routine hospice practice (B). We aimed to evaluate whether PST has a detrimental effect on survival in terminally ill patients. Palliative sedation therapy (PST) is indicated for and used to control refractory symptoms in cancer patients undergoing palliative care.

Hasten death