White, N; Reid, F; Harries, P; Harris, AJL; Minton, O; McGowan, C; Lodge, P; Tookman, A; Stone, P
(2019)
The (un)availability of prognostic information in the last days of life: a prospective observational study.
BMJ Open, 9 (7).
e030736.
ISSN 2044-6055
https://doi.org/10.1136/bmjopen-2019-030736
SGUL Authors: McGowan, Catherine Margaret
Abstract
OBJECTIVES: The aims of this study were (1) to document the clinical condition of patients considered to be in the last 2 weeks of life and (2) to compare patients who did or did not survive for 72 hours. DESIGN: A prospective observational study. SETTING: Two sites in London, UK (a hospice and a hospital palliative care team). PARTICIPANTS: Any inpatient, over 18 years old, English speaking, who was identified by the palliative care team as at risk of dying within the next 2 weeks was eligible. OUTCOME MEASURES: Prognostic signs and symptoms were documented at a one off assessment and patients were followed up 7 days later to determine whether or not they had died. RESULTS: Fifty participants were recruited and 24/50 (48%) died within 72 hours of assessment. The most prevalent prognostic features observed were a decrease in oral food intake (60%) and a rapid decline of the participant's global health status (56%). Participants who died within 72 hours had a lower level of consciousness and had more care needs than those who lived longer. A large portion of data was unavailable, particularly that relating to the psychological and spiritual well-being of the patient, due to the decreased consciousness of the patient. CONCLUSIONS: The prevalence of prognostic signs and symptoms in the final days of life has been documented between those predicted to die and those who did not. How doctors make decisions with missing information is an area for future research, in addition to understanding the best way to use the available information to make more accurate predictions.
Item Type: |
Article
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Additional Information: |
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
Keywords: |
dying, palliative care, prognosis |
SGUL Research Institute / Research Centre: |
Academic Structure > Institute of Medical, Biomedical and Allied Health Education (IMBE) |
Journal or Publication Title: |
BMJ Open |
ISSN: |
2044-6055 |
Language: |
eng |
Dates: |
Date | Event |
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9 July 2019 | Published | 20 June 2019 | Accepted |
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Publisher License: |
Creative Commons: Attribution-Noncommercial 4.0 |
Projects: |
Project ID | Funder | Funder ID |
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MCCC-FPO-16-U | Marie Curie Care | UNSPECIFIED |
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PubMed ID: |
31292186 |
Web of Science ID: |
WOS:000485269700282 |
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Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/111293 |
Publisher's version: |
https://doi.org/10.1136/bmjopen-2019-030736 |
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