Sedation is used to an increasing extent in end-of-life care. Definitions and indications in this field are based on expert opinions and case series.
Little is known about this practice at palliative care units in Austria.
Patients who died in Austrian palliative care units between June 2012 and June 2013 were identified.
A predefined set of baseline characteristics and information on sedation during the last two weeks before death were obtained by reviewing the patients' charts.
The data of 2414 patients from 23 palliative care units were available for analysis.
Five hundred two ( 21% ) patients received sedation in the last two weeks preceding their death, 356 ( 71% ) received continuous sedation until death, and 119 ( 24% ) received intermittent sedation.
The median duration of sedation was 48 h ( IQR 10-72 h ); 168 patients ( 34% ) were sedated for less than 24 h.
Indications for sedation were delirium ( 51% ), existential distress ( 32% ), dyspnea ( 30% ), and pain ( 20% ).
Midazolam was the most frequently used drug ( 79% ), followed by Lorazepam ( 13% ), and Haloperidol ( 10% ).
Sedated patients were significantly younger ( median age 67 years vs. 74 years, p less than or equal to 0.001, r = 0.22 ), suffered more often from an oncological disease ( 92% vs. 82%, p less than or equal to 0.001, φ = 0.107 ), and were hospitalized more frequently ( 94% vs. 76%, p ≤less than or equal to 0.001, φ = 0.175 ).
The median number of days between admission to a palliative care ward/mobile palliative care team and death did not differ significantly in sedated versus non-sedated patients ( 10 vs. 9 days; p = 0.491 ).
In conclusion, this study provides insights into the practice of end-of-life sedation in Austria. ( Xagena )
Schur S et al, BMC Palliat Care 2016;15:50. doi: 10.1186/s12904-016-0121-8