TY - JOUR
T1 - Palliative Sedation at the End of Life
T2 - Patterns of Use in an Israeli Hospice
AU - Azoulay, Daniel
AU - Shahal-Gassner, Ruth
AU - Yehezkel, Malka
AU - Eliyahu, Ester
AU - Weigert, Nir
AU - Ein-Mor, Eliana
AU - Jacobs, Jeremy M.
N1 - Publisher Copyright:
© 2015, © The Author(s) 2015.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Palliative sedation (PS) is indicated for refractory symptoms among dying patients. This retrospective descriptive study examines PS in an Israeli hospice. Palliative sedation was defined as PS to unconsciousness (PSU), PS proportionate to symptoms (proportional palliative sedation [PPS]), or intermittent PS (IPS). Among 179 patients who died during 2012, PS was used among 21.2% (n = 38): (PSU 34.2%, PPS 34.2%, and IPS 31.6%), using midazolam (n = 33/38), halidol (21/38), and concurrent morphine (n = 35/38). Indications included agitation (71%), pain (36.8%), and dyspnea (21%). Survival following initiation of PS was 73 ± standard deviation 54 hours. No differences in survival were observed according to who initiated the decision to use PS (patients/medical staff/family) or type of PS (PSU/PPS/IPS). Survival following PS was longest with higher sedative doses, an observation that may help dispel fears concerning the use of PS to hasten death.
AB - Palliative sedation (PS) is indicated for refractory symptoms among dying patients. This retrospective descriptive study examines PS in an Israeli hospice. Palliative sedation was defined as PS to unconsciousness (PSU), PS proportionate to symptoms (proportional palliative sedation [PPS]), or intermittent PS (IPS). Among 179 patients who died during 2012, PS was used among 21.2% (n = 38): (PSU 34.2%, PPS 34.2%, and IPS 31.6%), using midazolam (n = 33/38), halidol (21/38), and concurrent morphine (n = 35/38). Indications included agitation (71%), pain (36.8%), and dyspnea (21%). Survival following initiation of PS was 73 ± standard deviation 54 hours. No differences in survival were observed according to who initiated the decision to use PS (patients/medical staff/family) or type of PS (PSU/PPS/IPS). Survival following PS was longest with higher sedative doses, an observation that may help dispel fears concerning the use of PS to hasten death.
KW - end-of-life care
KW - hospice
KW - palliative care
KW - palliative sedation
KW - survival
KW - terminal sedation
UR - http://www.scopus.com/inward/record.url?scp=84961237873&partnerID=8YFLogxK
U2 - 10.1177/1049909115572991
DO - 10.1177/1049909115572991
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C2 - 25701661
AN - SCOPUS:84961237873
SN - 1049-9091
VL - 33
SP - 369
EP - 373
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 4
ER -