| A Retrospective Analysis of Primary Diagnosis, Comorbidities, Anticholinergic Load, and Other Factors on Treatment for Noisy Respiratory Secretions at the End of Life. | |
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MedLine Citation:
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PMID: 21883008 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract Background: Noisy respiratory secretions (NRS) at the end of life have been described in 23%-92% of deaths in palliative care units. Despite limited evidence to support the efficacy of the antisecretory medications, hyoscine hydrobromide and glycopyrrolate, administration of these medications remains standard palliation. Predicting those at risk of NRS could allow early and targeted intervention. Methods: A retrospective analysis of 199 deaths in a palliative care unit was undertaken to identify if any patient, disease, or treatment-related factors might be predictive or protective of the symptom. Results: In the last 72 hours of life, 60% received antisecretory medication (mean, 2; range, 0-16 doses). Significant unadjusted associations were found between administration of antisecretory medications and survival as well as the anticholinergic drug load from other medications. Results obtained from logistic regressions revealed patients with a higher anticholinergic load from prescribed medications were more likely to require treatment for NRS (odds ratio [OR]=2.9, 95% confidence interval [CI]=1.4-5.7). There were no other factors significantly associated with developing the symptom. Conclusion: A high anticholinergic load from medications was not protective and instead predicted the need for treatment for NRS at the end of life. |
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Authors:
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Caitlin Sheehan; Katherine Clark; Lawrence Lam; Richard Chye |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-1 |
Journal Detail:
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Title: Journal of palliative medicine Volume: - ISSN: 1557-7740 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9808462 Medline TA: J Palliat Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 The Cunningham Centre for Palliative Care , Darlinghurst, New South Wales, Australia . |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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