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dc.contributor.authorDavid C. Currowen_US
dc.contributor.authorJoanna M. Smithen_US
dc.contributor.authorPhichai Chansriwongen_US
dc.contributor.authorSimon I.R. Nobleen_US
dc.contributor.authorTheodora Nikolaidouen_US
dc.contributor.authorDiana Ferreiraen_US
dc.contributor.authorMiriam J. Johnsonen_US
dc.contributor.authorMagnus Ekströmen_US
dc.contributor.otherHull York Medical Schoolen_US
dc.contributor.otherSilver Chainen_US
dc.contributor.otherLunds Universiteten_US
dc.contributor.otherCardiff Universityen_US
dc.contributor.otherUniversity of Technology Sydneyen_US
dc.contributor.otherFlinders Universityen_US
dc.contributor.otherFaculty of Medicine, Ramathibodi Hospital, Mahidol Universityen_US
dc.identifier.citationEuropean Respiratory Journal. Vol.52, No.3 (2018)en_US
dc.description.abstractCopyright ©ERS 2018 The aim of the study was to explore trajectories of breathlessness intensity by function and life-limiting illness diagnosis in the last 3 weeks of life in palliative care patients. A prospective, consecutive cohort study obtained point-of-care data of patients of Silver Chain Hospice Care Service (Perth, Australia) over the period 2011–2014 (n=6801; 51494 data-points). Breathlessness intensity (0–10 numerical rating scale) and physical function (Australia-modified Karnofsky Performance Status (AKPS)) were measured at each visit. Time was anchored at death. Breathlessness trajectory was analysed by physical function and diagnosis using mixed effects regression. Mean±SD age was 71.5±15.1 years and 55.2% were male, most with cancer. The last recorded AKPS was >40 for 26.8%. Breathlessness was worst in people with cardiorespiratory disease and AKPS >40, and breathlessness in the last week of life increased most in this group (adjusted mean 2.92 versus all others 1.51; p=0.0001). The only significant interaction was with diagnosis and function in the last week of life (p<0.0001). Breathlessness is more intense and increases more in people with better function and cardiorespiratory disease immediately before death. Whether there are reversible causes for these people should be explored prospectively. Omitting function from previous population estimates may have overestimated breathlessness intensity for many patients in the days preceding death.en_US
dc.rightsMahidol Universityen_US
dc.titleMissed opportunity? Worsening breathlessness as a harbinger of death: A cohort studyen_US
Appears in Collections:Scopus 2018

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