2 research outputs found
Survival Outcomes in Palliative Sedation Based on Referring Versus On-Call Physician Prescription
This study sought to determine the survival duration of patients who underwent palliative
sedation, comparing those who received prescriptions from referring physicians versus on-call
physicians. It included all patients over 18 years old who died in the Palliative Care, Internal
Medicine, and Oncology units at the Hospital Universitario of Jerez de la Frontera between 1 January
2019, and 31 December 2019. Various factors were analyzed, including age, gender, oncological
or non-oncological disease, type of primary tumor and refractory symptoms. Statistical analysis
was employed to compare survival times between patients who received palliative sedation from
referring physicians and those prescribed by on-call physicians, while accounting for other potential
confounding variables. This study revealed that the median survival time after the initiation of
palliative sedation was 25 h, with an interquartile range of 8 to 48 h. Notably, if the sedation was
prescribed by referring physicians, the median survival time was 30 h, while it decreased to 17 h when
prescribed by on-call physicians (RR 0.357; 95% CI 0.146–0.873; p = 0.024). Furthermore, dyspnea
as a refractory symptom was associated with a shorter survival time (RR 0.307; 95% CI 0.095–0.985;
p = 0.047). The findings suggest that the on-call physician often administered palliative sedation to
rapidly deteriorating patients, particularly those experiencing dyspnea, which likely contributed to
the shorter survival time following sedation initiation. This study underscores the importance of
careful patient selection and prompt initiation of palliative sedation to alleviate suffering