Dying With Dyspnea in the Hospital

The American Journal of Hospice & Palliative Care
Deborah Morris, Marissa Galicia-Castillo

Abstract

While many patients hope to die at home, many die in hospitals. Patients die with unrecognized and untreated symptoms including dyspnea. We sought to determine prevalence of dyspnea at end of life in patients dying in acute hospital care and examine treatment patterns. A retrospective chart review of deaths at tertiary care hospital over a 3-month period evaluated dyspnea in last 24 hours of life, opioid orders and administration as well as presence of palliative care consultation. Of 106 decedents, 88 experienced dyspnea or tachypnea in last 24 hours of life. Health care providers noted only 50% as dyspneic, even those undergoing terminal comfort extubation. Almost all patients with dyspnea documented by staff had orders and received opioids; however, few orders described treatment specifically for dyspnea. Patients with palliative care consultations more often received opioids ( P = .0007), and opioid orders more often specified treatment of dyspnea ( P = .013). These findings support that previous work noting many patients experience dyspnea at end of life. Despite national guidelines, health care providers may still be underrecognizing and likely not optimally treating dyspnea at the end of life in the hospital. Collaborati...Continue Reading

References

Jul 29, 1998·Archives of Internal Medicine·S J GoodlinJ Lynn
Aug 9, 2007·Medical Care Research and Review : MCRR·Andrea GruneirJason Roy
Jul 21, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·C MazzocatoP Michel
Oct 8, 2009·Journal of Palliative Medicine·Margaret L CampbellJulia Walch
Jan 19, 2010·Journal of Palliative Medicine·Margaret L CampbellJulia Walch
Jun 30, 2010·Archives of Internal Medicine·Anne M WallingNeil S Wenger
Apr 4, 2012·Current Opinion in Supportive and Palliative Care·Margaret L Campbell
Oct 12, 2013·The American Journal of Nursing·Kathy BakerRobert Banzett
Feb 19, 2014·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Steffen T SimonFriedemann Nauck
Jul 1, 2014·Current Opinion in Supportive and Palliative Care·Alex H Gifford
Jul 6, 2014·Journal of the National Comprehensive Cancer Network : JNCCN·Thomas W LeBlanc, Amy P Abernethy
Jan 4, 2015·BMJ : British Medical Journal·Magnus P EkströmDavid C Currow

❮ Previous
Next ❯

Citations

Feb 26, 2019·The American Journal of Hospice & Palliative Care·Maki Murakami

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.