Sedation at the end of life - a nation-wide study in palliative care units in Austria

AUPACS (Austrian Palliative Care Study) Group, Gudrun Kreye

Research output: Journal article (peer-reviewed)Journal article

36 Citations (Scopus)

Abstract

BACKGROUND: Sedation is used to an increasing extent in end-of-life care. Definitions and indications in this field are based on expert opinions and case series. Little is known about this practice at palliative care units in Austria.

METHODS: Patients who died in Austrian palliative care units between June 2012 and June 2013 were identified. A predefined set of baseline characteristics and information on sedation during the last two weeks before death were obtained by reviewing the patients' charts.

RESULTS: The data of 2414 patients from 23 palliative care units were available for analysis. Five hundred two (21 %) patients received sedation in the last two weeks preceding their death, 356 (71 %) received continuous sedation until death, and 119 (24 %) received intermittent sedation. The median duration of sedation was 48 h (IQR 10-72 h); 168 patients (34 %) were sedated for less than 24 h. Indications for sedation were delirium (51 %), existential distress (32 %), dyspnea (30 %), and pain (20 %). Midazolam was the most frequently used drug (79 %), followed by lorazepam (13 %), and haloperidol (10 %). Sedated patients were significantly younger (median age 67 years vs. 74 years, p ≤ 0.001, r = 0.22), suffered more often from an oncological disease (92 % vs. 82 %, p ≤ 0.001, φ = 0.107), and were hospitalized more frequently (94 % vs. 76 %, p ≤ 0.001, φ = 0.175). The median number of days between admission to a palliative care ward/mobile palliative care team and death did not differ significantly in sedated versus non-sedated patients (10 vs. 9 days; p = 0.491).

CONCLUSION: This study provides insights into the practice of end-of-life sedation in Austria. Critical appraisal of these data will serve as a starting point for the development of nation-wide guidelines for palliative sedation in Austria.

Original languageEnglish
Article number50
Pages (from-to)50
JournalBMC Palliative Care
Volume15
Issue number1
DOIs
Publication statusPublished - 14 May 2016

Keywords

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Austria
  • Deep Sedation/methods
  • Delirium/drug therapy
  • Dyspnea
  • Female
  • Humans
  • Hypnotics and Sedatives/therapeutic use
  • Male
  • Middle Aged
  • Pain/drug therapy
  • Palliative Care/methods
  • Patient Comfort
  • Retrospective Studies
  • Sex Factors
  • Stress, Psychological/drug therapy
  • Terminal Care/methods
  • Time Factors
  • Sedation
  • Symptom management
  • Palliative care

ASJC Scopus subject areas

  • Medicine (all)

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