Prevalence of Sudden Death in Palliative Care: Data From the Australian Palliative Care Outcomes Collaboration

Ekström, M; Vergo, MT; Ahmadi, Z; Currow, DC

Prevalence of Sudden Death in Palliative Care: Data From the Australian Palliative Care Outcomes Collaboration

Ekström, M Vergo, MT Ahmadi, Z Currow, DC

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Publication Type:: Journal Article
Citation:: Journal of Pain and Symptom Management, 2016, 52 (2), pp. 221 - 227
Issue Date:: 2016-08-01

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Field	Value	Language
dc.contributor.author	Ekström, M	en_US
dc.contributor.author	Vergo, MT	en_US
dc.contributor.author	Ahmadi, Z	en_US
dc.contributor.author	Currow, DC https://orcid.org/0000-0003-1988-1250	en_US
dc.date.available	2016-02-13	en_US
dc.date.issued	2016-08-01	en_US
dc.identifier.citation	Journal of Pain and Symptom Management, 2016, 52 (2), pp. 221 - 227	en_US
dc.identifier.issn	0885-3924	en_US
dc.identifier.uri	http://hdl.handle.net/10453/105381
dc.description.abstract	© 2016 American Academy of Hospice and Palliative Medicine Context Advanced, life-limiting illnesses are likely to have a predictable functional decline through a terminal phase to death, but some patients may also die suddenly. To date, empirical evidence characterizing “sudden death” in hospice/palliative care is lacking. Objectives The aim of this study was to determine prevalence and clinicodemographic predictors of sudden death in hospice/palliative care. Methods This is a longitudinal consecutive cohort study of prospectively collected national data in 104 specialist palliative care services from the Australian Palliative Care Outcomes Collaboration. Patients who died between July 1, 2013, and June 30, 2014, with one or more measurement of Australian-modified Karnofsky Performance Status (AKPS) in the last 30 days of life were included. “Sudden death” was defined as a lowest AKPS score of 50 or more in the last seven days of life and excluded anyone with “terminal phase” as their last phase before death. Predictors were defined using logistic regression. Results In total, 13,966 patients were included, mean age 73.6 (SD 13.6) years, 46% women, and 77% had cancer. During the seven days before death, there were 20,992 AKPS measurements; median 1 (interquartile range 1–2) per patient. Four percent of deaths (one of 25) were sudden, predicted independently by having lung cancer (odds ratio [OR] 2.64), cardiovascular disease (OR 1.94), other cancers (OR 1.63), being male (OR 1.23), younger, worse fatigue, and worse breathlessness. Sudden death was associated with higher rates of death at home (OR 3.2; 95% CI 2.9 to 3.6). Conclusion This study quantifies rates of sudden death in hospice/palliative care and has implications for conversations about prognosis between clinicians, patients, and their families.	en_US
dc.relation.ispartof	Journal of Pain and Symptom Management	en_US
dc.relation.isbasedon	10.1016/j.jpainsymman.2016.02.015	en_US
dc.subject.classification	Anesthesiology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neoplasms	en_US
dc.subject.mesh	Dyspnea	en_US
dc.subject.mesh	Cardiovascular Diseases	en_US
dc.subject.mesh	Death, Sudden	en_US
dc.subject.mesh	Fatigue	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Karnofsky Performance Status	en_US
dc.subject.mesh	Prevalence	en_US
dc.subject.mesh	Logistic Models	en_US
dc.subject.mesh	Odds Ratio	en_US
dc.subject.mesh	Longitudinal Studies	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Socioeconomic Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Prevalence of Sudden Death in Palliative Care: Data From the Australian Palliative Care Outcomes Collaboration	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	52	en_US
utslib.for	1110 Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	52	en_US

Abstract:

© 2016 American Academy of Hospice and Palliative Medicine Context Advanced, life-limiting illnesses are likely to have a predictable functional decline through a terminal phase to death, but some patients may also die suddenly. To date, empirical evidence characterizing “sudden death” in hospice/palliative care is lacking. Objectives The aim of this study was to determine prevalence and clinicodemographic predictors of sudden death in hospice/palliative care. Methods This is a longitudinal consecutive cohort study of prospectively collected national data in 104 specialist palliative care services from the Australian Palliative Care Outcomes Collaboration. Patients who died between July 1, 2013, and June 30, 2014, with one or more measurement of Australian-modified Karnofsky Performance Status (AKPS) in the last 30 days of life were included. “Sudden death” was defined as a lowest AKPS score of 50 or more in the last seven days of life and excluded anyone with “terminal phase” as their last phase before death. Predictors were defined using logistic regression. Results In total, 13,966 patients were included, mean age 73.6 (SD 13.6) years, 46% women, and 77% had cancer. During the seven days before death, there were 20,992 AKPS measurements; median 1 (interquartile range 1–2) per patient. Four percent of deaths (one of 25) were sudden, predicted independently by having lung cancer (odds ratio [OR] 2.64), cardiovascular disease (OR 1.94), other cancers (OR 1.63), being male (OR 1.23), younger, worse fatigue, and worse breathlessness. Sudden death was associated with higher rates of death at home (OR 3.2; 95% CI 2.9 to 3.6). Conclusion This study quantifies rates of sudden death in hospice/palliative care and has implications for conversations about prognosis between clinicians, patients, and their families.

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http://hdl.handle.net/10453/105381