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Assessment of Changes in Symptoms Is Feasible and Prognostic in the Last Weeks of Life: An International Multicenter Cohort Study.

Publication ,  Journal Article
Suh, S-Y; Won, S-H; Hiratsuka, Y; Choi, S-E; Cheng, S-Y; Mori, M; Chen, P-J; Yamaguchi, T; Morita, T; Tsuneto, S; LeBlanc, TW; Kim, S-H ...
Published in: J Palliat Med
March 2022

Background: Symptoms are not typically part of established various prognostic factors and scoring systems but are among the most frequently assessed issues in patient care. Objectives: To evaluate that, changes in symptoms can provide additional useful prognostic information. Design: A secondary analysis of an international cohort study in Japan, Korea, and Taiwan. Setting/Subjects: Subjects were adult patients with advanced cancer (n = 2074) who were admitted to 37 palliative care units (PCUs) in 3 countries from January 2017 to September 2018. Measurements: Symptoms (dyspnea, fatigue, dry mouth, and drowsiness) were assessed at admission and one-week later. Dyspnea was assessed by the presence of resting and exertional dyspnea, whereas other symptoms were assessed using the Integrated Palliative care Outcome Scales (IPOS) (range 0-4). For analysis, we grouped patients by symptom change, as either Improved, Stable, or Worsened (by having at least a one increment decrease, no change, or at least a one increment increase, respectively). Results: Worsened groups had the shortest survival (median survival 15-21 days) compared with those with Improved (median survival 23-31 days) and Stable symptoms (median survival 27-29 days) across all four symptoms (dyspnea, fatigue, dry mouth, and drowsiness). Survival differences were statistically significantly different across all three groups for all symptoms (all p < 0.001). Interestingly, Improved symptoms were associated with similar survival compared with Stable groups, with no statistical differences. Conclusions: Worsened symptoms at one week after admission were useful predictors of survival for patients with advanced cancer in PCUs during the final weeks of life. Longitudinal assessments are needed to reflect passage of time as well as impact of treatments.

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Published In

J Palliat Med

DOI

EISSN

1557-7740

Publication Date

March 2022

Volume

25

Issue

3

Start / End Page

388 / 395

Location

United States

Related Subject Headings

  • Republic of Korea
  • Prognosis
  • Palliative Care
  • Neoplasms
  • Humans
  • Gerontology
  • Cohort Studies
  • Adult
  • 4205 Nursing
  • 4203 Health services and systems
 

Citation

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Suh, S.-Y., Won, S.-H., Hiratsuka, Y., Choi, S.-E., Cheng, S.-Y., Mori, M., … Hwang, S. W. (2022). Assessment of Changes in Symptoms Is Feasible and Prognostic in the Last Weeks of Life: An International Multicenter Cohort Study. J Palliat Med, 25(3), 388–395. https://doi.org/10.1089/jpm.2021.0212
Suh, Sang-Yeon, Seon-Hye Won, Yusuke Hiratsuka, Sung-Eun Choi, Shao-Yi Cheng, Masanori Mori, Ping-Jen Chen, et al. “Assessment of Changes in Symptoms Is Feasible and Prognostic in the Last Weeks of Life: An International Multicenter Cohort Study.J Palliat Med 25, no. 3 (March 2022): 388–95. https://doi.org/10.1089/jpm.2021.0212.
Suh S-Y, Won S-H, Hiratsuka Y, Choi S-E, Cheng S-Y, Mori M, et al. Assessment of Changes in Symptoms Is Feasible and Prognostic in the Last Weeks of Life: An International Multicenter Cohort Study. J Palliat Med. 2022 Mar;25(3):388–95.
Suh, Sang-Yeon, et al. “Assessment of Changes in Symptoms Is Feasible and Prognostic in the Last Weeks of Life: An International Multicenter Cohort Study.J Palliat Med, vol. 25, no. 3, Mar. 2022, pp. 388–95. Pubmed, doi:10.1089/jpm.2021.0212.
Suh S-Y, Won S-H, Hiratsuka Y, Choi S-E, Cheng S-Y, Mori M, Chen P-J, Yamaguchi T, Morita T, Tsuneto S, LeBlanc TW, Kim S-H, Yoon S-J, Lee ES, Hwang SW. Assessment of Changes in Symptoms Is Feasible and Prognostic in the Last Weeks of Life: An International Multicenter Cohort Study. J Palliat Med. 2022 Mar;25(3):388–395.
Journal cover image

Published In

J Palliat Med

DOI

EISSN

1557-7740

Publication Date

March 2022

Volume

25

Issue

3

Start / End Page

388 / 395

Location

United States

Related Subject Headings

  • Republic of Korea
  • Prognosis
  • Palliative Care
  • Neoplasms
  • Humans
  • Gerontology
  • Cohort Studies
  • Adult
  • 4205 Nursing
  • 4203 Health services and systems