Book Description

IntroductionPrediction of impending death is of great concern to terminally ill cancer patients. Several prediction tools developed previously are rather complex to use by health care providers.ObjectivesTo assess the clinical efficacy of the changing pattern of vital sign to predict survival in this population.MethodsWe retrospectively assessed all patients who died of advanced cancer from 2009 to 2013 and who were not treated with chemotherapy during the last 6 weeks of life. Patientu2019s vital signs during the last 8 days of life were reviewed and analyzed for its association with death.ResultsA total of 1,357 patients were included. Mean systolic (SBP) and diastolic blood pressure (DBP) abruptly decreased during the last day of life. Mean respiratory rate (RR) apparently increased since 2 days before death. Mean heart rate (HR) consistently increased and there was small difference of mean body temperature (BT) during the last 8 days of life. Based on the difference amounts of each vital sign, we defined the u201cvital sign risku201d to die within 3 days according to the following risks: SBP decrease u226510 mmHg, DBP decrease u226510 mmHg, HR increase u226510/min, RR increase u22655/min, and BT increase u22650.5u00b0C. The matched odds ratios for death within 3 days were 6.5, 11.1, 5.9, 14.8, and 3.4 in each vital sign risk compared with their counterparts. The positive predictive values for death within 3 days were 90.2%, 92.7%, 89.9%, 94.2%, and 80.4%, respectively.ConclusionThe changing pattern of vital sign is useful to predict survival in terminally ill cancer patients.