Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos

Pedro Barata; Filipa Santos; Graça Mesquita; Alice Cardoso; Maria Paula Custódio; Marta Alves; Ana Luísa Papoila; António Barbosa; Peter Lawlor

doi:10.20344/amp.7557

Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care

Authors

Pedro Barata Serviço de Oncologia Médica. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
Filipa Santos Departamento de Ciências Biomédicas e Medicina. Universidade do Algarve. Faro. Portugal.
Graça Mesquita Unidade de Dor Crónica. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
Alice Cardoso Cuidados Paliativos. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
Maria Paula Custódio Serviço de Oncologia Médica. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
Marta Alves Gabinete de Análise Epidemiológica e Estatística. Centro de Investigação. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
Ana Luísa Papoila Gabinete de Análise Epidemiológica e Estatística. Centro de Investigação. Centro Hospitalar Lisboa Central. Lisboa. Portugal.
António Barbosa Centro de Bioética. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.
Peter Lawlor Cuidados Paliativos. Institutos de Investigação de Bruyere e Ottawa. Universidade de Ottawa. Ottawa. Canadá.

DOI:

https://doi.org/10.20344/amp.7557

Keywords:

Neoplasms, Pain Measurement, Palliative Care.

Abstract

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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Published

2016-11-30

How to Cite

Barata P, Santos F, Mesquita G, Cardoso A, Custódio MP, Alves M, Papoila AL, Barbosa A, Lawlor P. Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care. Acta Med Port [Internet]. 2016 Nov. 30 [cited 2024 Dec. 22];29(11):694-701. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/7557

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Issue

Vol. 29 No. 11 (2016): November

Section

Original

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