Anticholinergic drugs for death rattle in dying patients with cancer: multicentre prospective cohort study.
Anticholinergic drugs for death rattle in dying patients with cancer: multicentre prospective cohort study.
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抗胆碱能药物治疗垂死癌症患者的临终声音：多中心前瞻性队列研究。
DOI：
10.1136/spcare-2022-003823
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Mori M.
中科院分区：
文献类型：
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作者：
Yamaguchi T;Yokomichi N;Yamaguchi T;Maeda I;Matsunuma R;Tanaka-Yagi Y;Akatani A;Suzuki K;Kohara H;Taniyama T;Matsuda Y;Nakajima N;Morita T;Tsuneto S;Mori M.
BackgroundThis study aims to investigate effectiveness of anticholinergics（AC）for death rattle in dying patients with cancer.MethodsThis is a prospective cohort study enrolled Terminally ill adult（20岁或以上）patients with cancer who developed substantial death rattle（Back score ≥2）from 23 palliative care units in Japan.根据主治医生的决定，对死亡摇铃进行AC治疗。主要结局是临终前的啰音改善的患者比例，其定义为Back评分≤1。我们比较了（AC组）和无（非AC组）AC，采用倾向评分weighting.ResultsOf的1896例患者中，控制潜在的混杂因素治疗的患者的改善病例的比例，我们包括196谁开发了大量的死亡摇铃。其中，81人获得了AC。基线后8小时，AC组中56.8%和非AC组中35.4%的患者的死亡啰音改善。在加权分析中，AC组在死亡拍击方面表现出显著改善，调整后OR为4.47（95% CI 2.04至9.78; p=0.0024）。所有敏感性分析均获得基本相同的结果。在亚组分析中，AC与男性、肺癌患者和1型死亡患者的死亡震颤改善密切相关（校正OR分别为5.81，8.38和9.32）。结论在此倾向评分加权分析中，AC与晚期癌症患者的死亡震颤改善相关，这些患者出现了实质性的死亡震颤。（UMIN00002545）。
BackgroundThis study aimed to investigate the effectiveness of anticholinergics (AC) for death rattle in dying patients with cancer.MethodsThis is a prospective cohort study enrolled Terminally ill adult (20 years or older) patients with cancer who developed substantial death rattle (Back score ≥2) from 23 palliative care units in Japan. AC treatment for death rattle was prescribed according to primary physician’s decision. The primary outcome was the proportion of patients whose death rattle improved, which was defined as a Back score of ≤1. We compared the proportion of improved cases in patients treated with (AC group) and without (non-AC group) AC, controlling potential confounders by employing propensity score weighting.ResultsOf the 1896 patients enrolled, we included 196 who developed a substantial death rattle. Of these, 81 received AC. 56.8% in the AC group and 35.4% in the non-AC group had an improved death rattle at 8 hours after baseline. In the weighted analysis, AC group showed significant improvements in death rattle, with an adjusted OR of 4.47 (95% CI 2.04 to 9.78; p=0.0024). All sensitivity analyses achieved essentially the same results. In the subgroup analysis, ACs were strongly associated with death rattle improvement in men, patients with lung cancer, and type 1 death rattle (adjusted OR 5.81, 8.38 and 9.32, respectively).ConclusionsIn this propensity score-weighted analysis, ACs were associated with death rattle improvement in terminally ill patients with cancer who developed substantial death rattle.Trial registration numberUMIN-CTR (UMIN00002545).