Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557 |
Resumo: | Introduction: Pain is a common symptom experienced by cancer patients, especially in those with advanced disease. Our aim was to describe pain intensity in advanced cancer patients, referred to the palliative care unit, the factors underlying moderate to severe pain and its prognostic values.Material and Methods: This was a prospective observational study. All patients with mestastatic solid tumors and with no specific oncologic treatment were included. Pain intensity was accessed using the pain scale from Edmonton Symptom Assessment Scale, rated from 0 to 10 on a numerical scale, where zero = no pain and 10 = worst possible pain.Results: Between October 2012 and June 2015, a total of 301 patients participated in the study. The median age was 69 years, (37 - 94); most of the patients were men (57%) and 64.8% had a performance status of 3/4. About 42% reported pain severity ≥ 4 and 74% were medicated with opioids. Multivariate analysis indicated a correlation between performance status and reported pain (OR: 1.7; IC 95%: 1.0 - 2.7; p = 0.045). Median overall survival was 37 days (IC 95%: 28 - 46). Patients reporting moderate to severe pain (pain severity ≥ 4) had a median survival of 29 days (IC 95%: 21 - 37), comparing with those who had no or moderate pain with median survival of 49 days (IC 95%: 35 - 63) (p = 0.022).Discussion: The performance status was associated with more intense pain. The performance status, hospitalization, intra-abdominal metastization and opioid analgesia were associated with shorter time to death in advanced cancer patients referred to palliative care.Conclusion: Cancer pain continues to be a major clinical problem in advanced cancer patients. |
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Pain Intensity and Time to Death of Cancer Patients Referred to Palliative CareAssociação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados PaliativosNeoplasmsPain MeasurementPalliative Care.Cuidados PaliativosMedição da DorNeoplasias.Introduction: Pain is a common symptom experienced by cancer patients, especially in those with advanced disease. Our aim was to describe pain intensity in advanced cancer patients, referred to the palliative care unit, the factors underlying moderate to severe pain and its prognostic values.Material and Methods: This was a prospective observational study. All patients with mestastatic solid tumors and with no specific oncologic treatment were included. Pain intensity was accessed using the pain scale from Edmonton Symptom Assessment Scale, rated from 0 to 10 on a numerical scale, where zero = no pain and 10 = worst possible pain.Results: Between October 2012 and June 2015, a total of 301 patients participated in the study. The median age was 69 years, (37 - 94); most of the patients were men (57%) and 64.8% had a performance status of 3/4. About 42% reported pain severity ≥ 4 and 74% were medicated with opioids. Multivariate analysis indicated a correlation between performance status and reported pain (OR: 1.7; IC 95%: 1.0 - 2.7; p = 0.045). Median overall survival was 37 days (IC 95%: 28 - 46). Patients reporting moderate to severe pain (pain severity ≥ 4) had a median survival of 29 days (IC 95%: 21 - 37), comparing with those who had no or moderate pain with median survival of 49 days (IC 95%: 35 - 63) (p = 0.022).Discussion: The performance status was associated with more intense pain. The performance status, hospitalization, intra-abdominal metastization and opioid analgesia were associated with shorter time to death in advanced cancer patients referred to palliative care.Conclusion: Cancer pain continues to be a major clinical problem in advanced cancer patients.Introdução: A dor é uma experiência frequente nos doentes com cancro, especialmente naqueles em fase final de vida. Com este estudo, pretendemos estudar a intensidade de dor nos doentes com cancro avançado, referenciados aos cuidados paliativos, analisar os factores associados à ocorrência de dor moderada ou intensa e avaliar a sua relação com o tempo até à morte destes doentes.Material e Métodos: Estudo prospectivo observacional que incluiu consecutivamente todos os doentes referenciados aos cuidados paliativos com tumores sólidos metastizados e sem tratamento oncológico específico. Foi considerada a intensidade de dor da escala de Edmonton, de acordo com a graduação zero a 10, onde 0 = ausência de dor e 10 = máxima dor possível.Resultados: Entre outubro de 2012 e junho de 2015, foram incluídos 301 doentes, com idade mediana de 69 anos (37 - 94), 57% homens e 64,8% dos doentes com performance status 3/4. Aproximadamente 42% dos doentes apresentaram dor ≥ 4 e cerca de 74,4% estavam medicados com analgesia opióide. A intensidade de dor esteve associada ao performance status dos doentes, de acordo com a análise multivariável (OR: 1,7; IC 95%: 1,0 - 2,7; p = 0,045). A mediana do tempo de sobrevivência foi de 37 dias (IC 95%: 28 - 46), tendo os doentes com dor moderada ou intensa (intensidade de dor ≥ 4) uma mediana de sobrevivência de 29 dias (IC 95%: 21 - 37), comparada com os 49 dias (IC 95%: 35 - 63) para os doentes sem dor ou dor ligeira (p = 0,022).Discussão: O performance status, para além de ter estado associado a uma maior intensidade de dor, esteve associado a um menor tempo até à morte dos doentes com cancro avançado referenciados aos cuidados paliativos. Também o internamento, a presença de metastização intra-abdominal e a analgesia opióide estiveram associados de forma negativa ao tempo até à morte destes doentes.Conclusão: A dor oncológica continua a ser um problema clinicamente relevante nos doentes com cancro avançado.Ordem dos Médicos2016-11-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557oai:ojs.www.actamedicaportuguesa.com:article/7557Acta Médica Portuguesa; Vol. 29 No. 11 (2016): November; 694-701Acta Médica Portuguesa; Vol. 29 N.º 11 (2016): Novembro; 694-7011646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/4818https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/8338https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/8568https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/8607Direitos de Autor (c) 2016 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessBarata, PedroSantos, FilipaMesquita, GraçaCardoso, AliceCustódio, Maria PaulaAlves, MartaPapoila, Ana LuísaBarbosa, AntónioLawlor, Peter2022-12-20T11:05:15ZPortal AgregadorONG |
dc.title.none.fl_str_mv |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos |
title |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care |
spellingShingle |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care Barata, Pedro Neoplasms Pain Measurement Palliative Care. Cuidados Paliativos Medição da Dor Neoplasias. |
title_short |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care |
title_full |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care |
title_fullStr |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care |
title_full_unstemmed |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care |
title_sort |
Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care |
author |
Barata, Pedro |
author_facet |
Barata, Pedro Santos, Filipa Mesquita, Graça Cardoso, Alice Custódio, Maria Paula Alves, Marta Papoila, Ana Luísa Barbosa, António Lawlor, Peter |
author_role |
author |
author2 |
Santos, Filipa Mesquita, Graça Cardoso, Alice Custódio, Maria Paula Alves, Marta Papoila, Ana Luísa Barbosa, António Lawlor, Peter |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Barata, Pedro Santos, Filipa Mesquita, Graça Cardoso, Alice Custódio, Maria Paula Alves, Marta Papoila, Ana Luísa Barbosa, António Lawlor, Peter |
dc.subject.por.fl_str_mv |
Neoplasms Pain Measurement Palliative Care. Cuidados Paliativos Medição da Dor Neoplasias. |
topic |
Neoplasms Pain Measurement Palliative Care. Cuidados Paliativos Medição da Dor Neoplasias. |
description |
Introduction: Pain is a common symptom experienced by cancer patients, especially in those with advanced disease. Our aim was to describe pain intensity in advanced cancer patients, referred to the palliative care unit, the factors underlying moderate to severe pain and its prognostic values.Material and Methods: This was a prospective observational study. All patients with mestastatic solid tumors and with no specific oncologic treatment were included. Pain intensity was accessed using the pain scale from Edmonton Symptom Assessment Scale, rated from 0 to 10 on a numerical scale, where zero = no pain and 10 = worst possible pain.Results: Between October 2012 and June 2015, a total of 301 patients participated in the study. The median age was 69 years, (37 - 94); most of the patients were men (57%) and 64.8% had a performance status of 3/4. About 42% reported pain severity ≥ 4 and 74% were medicated with opioids. Multivariate analysis indicated a correlation between performance status and reported pain (OR: 1.7; IC 95%: 1.0 - 2.7; p = 0.045). Median overall survival was 37 days (IC 95%: 28 - 46). Patients reporting moderate to severe pain (pain severity ≥ 4) had a median survival of 29 days (IC 95%: 21 - 37), comparing with those who had no or moderate pain with median survival of 49 days (IC 95%: 35 - 63) (p = 0.022).Discussion: The performance status was associated with more intense pain. The performance status, hospitalization, intra-abdominal metastization and opioid analgesia were associated with shorter time to death in advanced cancer patients referred to palliative care.Conclusion: Cancer pain continues to be a major clinical problem in advanced cancer patients. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-11-30 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557 oai:ojs.www.actamedicaportuguesa.com:article/7557 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557 |
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oai:ojs.www.actamedicaportuguesa.com:article/7557 |
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por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/4818 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/8338 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/8568 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7557/8607 |
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Direitos de Autor (c) 2016 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2016 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 29 No. 11 (2016): November; 694-701 Acta Médica Portuguesa; Vol. 29 N.º 11 (2016): Novembro; 694-701 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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