Scientists found eight signs that predict incoming death in final-stage cancer patients with an overall accuracy of nearly 95 percent. According to the researchers, the eight symptoms should help the family and physician of the terminal ill patient take the best end-of-life decisions.
Researchers found that the eight signs usually predict death in cancer patients within 3 days. One of the most obvious signs of certain incoming death was the drooping of the smile lines, the nasolabial folds, as doctors call them. Nearly 80 percent of cancer patients who died at hospital displayed this symptom.
Another sign was the bleeding in the upper gastrointestinal tract (UGI bleed), also known as bleeding arising from the stomach, duodenum, or esophagus. This sign was the only non-neurological marker that foretells impending death.
The findings were the result of a clinical study conducted on 357 late-stage cancer patients. Each of the patients was monitored during their last days by observing cardiovascular, respiratory, gastrointestinal, genitourinary, neurologic, and integumentary systems twice a day.
Researchers used more than 50 near-death signs mentioned in the medical literature. On a 12-hour assessment, researchers looked for every sign and documented it as present or absent. Their main goal was to find those signs that with a more than 90 percent accuracy predicted incoming death in cancer patients, which is defined as death within 3 days.
About 200 patients involved in the study died at the hospital when the study was ongoing. Researchers noted that patients displayed many of the 50 signs that death was near. But only some signs recurrently appeared within the last three days of life. For instance, more than 90 percent of dying patients had a heart rate higher than 130 bpm, 90 percent had oxygen saturation lower than 90 percent, 97 percent of patients were losing conscience, while 89 percent entered delirium.
Authors of the study reported that between 38 percent and 78 percent of patients died within the three days after their bodies displayed several of the 8 specific signs:
1) the drooping of the nasolabial fold (78 percent)
2) decreased response to verbal stimuli (69 percent)
3) decreased response to visual stimuli (70 percent)
4) inability to close eyelids (57 percent)
5) Grunting of vocal cords (54 percent)
6) Hyperextension of neck (46 percent)
7) fixed pupils (38 percent)
8) UGI bleed (5 percent)
Researchers explained that upon further validation the telltale signs suggested that patients were dying with an accuracy of 94.9 percent to 99 percent.
“These objective bedside signs may assist clinicians, family members, and researchers in recognizing when the patient has entered the final days of life,”
Image Source: National Post
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