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%A Bruera, Sebastian; Chisholm, Gary; Dos Santos, Renata; Crovador, Camila; Bruera, Eduardo; Hui, David
%T Variations in vital signs in the last days of life in patients with advanced cancer.
%J Journal of pain and symptom management, vol. 48, no. 4, pp. 510-517
%D 10/2014
%V 48
%N 4
%M eng
%B Few studies have examined variation in vital signs in the last days of life.
%K Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Neoplasms, Physical Examination, Prospective Studies, Reproducibility of Results, Risk Assessment, Sensitivity and Specificity, Survival, Terminal Care, Terminally Ill, Vital Signs, Young Adult
%P 510
%L 517
%Y 10.1016/j.jpainsymman.2013.10.019
%W PHY
%G AUTHOR
%R 2014.......48..510B

@Article{Bruera2014,
author="Bruera, Sebastian
and Chisholm, Gary
and Dos Santos, Renata
and Crovador, Camila
and Bruera, Eduardo
and Hui, David",
title="Variations in vital signs in the last days of life in patients with advanced cancer.",
journal="Journal of pain and symptom management",
year="2014",
month="Oct",
day="14",
volume="48",
number="4",
pages="510--517",
keywords="Adolescent",
keywords="Adult",
keywords="Aged",
keywords="Aged, 80 and over",
keywords="Female",
keywords="Humans",
keywords="Incidence",
keywords="Longitudinal Studies",
keywords="Male",
keywords="Middle Aged",
keywords="Neoplasms",
keywords="Physical Examination",
keywords="Prospective Studies",
keywords="Reproducibility of Results",
keywords="Risk Assessment",
keywords="Sensitivity and Specificity",
keywords="Survival",
keywords="Terminal Care",
keywords="Terminally Ill",
keywords="Vital Signs",
keywords="Young Adult",
abstract="Few studies have examined variation in vital signs in the last days of life.",
issn="1873-6513",
doi="10.1016/j.jpainsymman.2013.10.019",
url="http://www.ncbi.nlm.nih.gov/pubmed/24731412",
language="eng"
}

%0 Journal Article
%T Variations in vital signs in the last days of life in patients with advanced cancer.
%A Bruera, Sebastian
%A Chisholm, Gary
%A Dos Santos, Renata
%A Crovador, Camila
%A Bruera, Eduardo
%A Hui, David
%J Journal of pain and symptom management
%D 2014
%8 Oct 14
%V 48
%N 4
%@ 1873-6513
%G eng
%F Bruera2014
%X Few studies have examined variation in vital signs in the last days of life.
%K Adolescent
%K Adult
%K Aged
%K Aged, 80 and over
%K Female
%K Humans
%K Incidence
%K Longitudinal Studies
%K Male
%K Middle Aged
%K Neoplasms
%K Physical Examination
%K Prospective Studies
%K Reproducibility of Results
%K Risk Assessment
%K Sensitivity and Specificity
%K Survival
%K Terminal Care
%K Terminally Ill
%K Vital Signs
%K Young Adult
%U http://dx.doi.org/10.1016/j.jpainsymman.2013.10.019
%U http://www.ncbi.nlm.nih.gov/pubmed/24731412
%P 510-517

PT Journal
AU Bruera, S
   Chisholm, G
   Dos Santos, R
   Crovador, C
   Bruera, E
   Hui, D
TI Variations in vital signs in the last days of life in patients with advanced cancer.
SO Journal of pain and symptom management
JI J Pain Symptom Manage
PD Oct
PY 2014
BP 510
EP 517
VL 48
IS 4
DI 10.1016/j.jpainsymman.2013.10.019
LA eng
DE Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Incidence; Longitudinal Studies; Male; Middle Aged; Neoplasms; Physical Examination; Prospective Studies; Reproducibility of Results; Risk Assessment; Sensitivity and Specificity; Survival; Terminal Care; Terminally Ill; Vital Signs; Young Adult
AB Few studies have examined variation in vital signs in the last days of life.
ER

PMID- 24731412
OWN - NLM
STAT- MEDLINE
DA  - 20141013
DCOM- 20150713
LR  - 20151001
IS  - 1873-6513 (Electronic)
IS  - 0885-3924 (Linking)
VI  - 48
IP  - 4
DP  - 2014 Oct
TI  - Variations in vital signs in the last days of life in patients with advanced
      cancer.
PG  - 510-7
LID - 10.1016/j.jpainsymman.2013.10.019 [doi]
LID - S0885-3924(14)00046-3 [pii]
AB  - CONTEXT: Few studies have examined variation in vital signs in the last days of
      life. OBJECTIVES: We determined the variation of vital signs in the final two
      weeks of life in patients with advanced cancer and examined their association
      with impending death in three days. METHODS: In this prospective, longitudinal,
      observational study, we enrolled consecutive patients admitted to two acute
      palliative care units and documented their vital signs (heart rate, blood
      pressure, respiratory rate, oxygen saturation, and temperature) twice a day
      serially from admission to death or discharge. RESULTS: Of 357 patients, 203
      (57%) died in hospital. Systolic blood pressure (P < 0.001), diastolic blood
      pressure (P < 0.001), and oxygen saturation (P < 0.001) decreased significantly
      in the final three days of life, and temperature increased slightly (P < 0.04).
      Heart rate (P = 0.22) and respiratory rate (P = 0.24) remained similar in the
      last three days. Impending death in three days was significantly associated with 
      increased heart rate (odds ratio [OR] = 2; P = 0.01), decreased systolic blood
      pressure (OR = 2.5; P = 0.004), decreased diastolic blood pressure (OR = 2.3; P =
      0.002), and decreased oxygen saturation (OR = 3.7; P = 0.003) from baseline
      readings on admission. These changes had high specificity (>/= 80%), low
      sensitivity (</= 35%), and modest positive likelihood ratios (</= 5) for
      impending death within three days. A large proportion of patients had normal
      vital signs in the last days of life. CONCLUSION: Blood pressure and oxygen
      saturation decreased in the last days of life. Clinicians and families cannot
      rely on vital sign changes alone to rule in or rule out impending death. Our
      findings do not support routine vital signs monitoring of patients who are
      imminently dying.
CI  - Copyright (c) 2014 American Academy of Hospice and Palliative Medicine. Published
      by Elsevier Inc. All rights reserved.
FAU - Bruera, Sebastian
AU  - Bruera S
AD  - Department of Palliative Care and Rehabilitation Medicine, The University of
      Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
FAU - Chisholm, Gary
AU  - Chisholm G
AD  - Department of Biostatistics, The University of Texas M. D. Anderson Cancer
      Center, Houston, Texas, USA.
FAU - Dos Santos, Renata
AU  - Dos Santos R
AD  - Department of Palliative Care, Barretos Cancer Hospital, Barretos, Brazil.
FAU - Crovador, Camila
AU  - Crovador C
AD  - Department of Palliative Care, Barretos Cancer Hospital, Barretos, Brazil.
FAU - Bruera, Eduardo
AU  - Bruera E
AD  - Department of Palliative Care and Rehabilitation Medicine, The University of
      Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
FAU - Hui, David
AU  - Hui D
AD  - Department of Palliative Care and Rehabilitation Medicine, The University of
      Texas M. D. Anderson Cancer Center, Houston, Texas, USA. Electronic address:
      [email protected]
LA  - eng
GR  - CA 016672/CA/NCI NIH HHS/United States
GR  - P30 CA016672/CA/NCI NIH HHS/United States
GR  - R01 CA122292/CA/NCI NIH HHS/United States
GR  - R01 CA124481/CA/NCI NIH HHS/United States
GR  - R01 NR010162/NR/NINR NIH HHS/United States
GR  - R01CA122292-01/CA/NCI NIH HHS/United States
GR  - R01CA124481-01/CA/NCI NIH HHS/United States
GR  - R01NR010162-01A1/NR/NINR NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
DEP - 20140414
PL  - United States
TA  - J Pain Symptom Manage
JT  - Journal of pain and symptom management
JID - 8605836
SB  - IM
CIN - J Pain Symptom Manage. 2014 Oct;48(4):499. PMID: 24937165
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/diagnosis/*epidemiology/*physiopathology
MH  - Physical Examination/*statistics & numerical data
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Risk Assessment/methods
MH  - Sensitivity and Specificity
MH  - Survival
MH  - Terminal Care/*statistics & numerical data
MH  - Terminally Ill/*statistics & numerical data
MH  - *Vital Signs
MH  - Young Adult
PMC - PMC4197073
MID - NIHMS561346
OID - NLM: NIHMS561346
OID - NLM: PMC4197073
OTO - NOTNLM
OT  - Blood pressure
OT  - death
OT  - diagnosis
OT  - heart rate
OT  - impending death
OT  - neoplasms
OT  - oxygen
OT  - physiologic phenomena
OT  - respiratory rate
OT  - temperature
EDAT- 2014/04/16 06:00
MHDA- 2015/07/15 06:00
CRDT- 2014/04/16 06:00
PHST- 2013/08/26 [received]
PHST- 2013/10/07 [revised]
PHST- 2013/10/30 [accepted]
PHST- 2014/04/14 [aheadofprint]
AID - S0885-3924(14)00046-3 [pii]
AID - 10.1016/j.jpainsymman.2013.10.019 [doi]
PST - ppublish
SO  - J Pain Symptom Manage. 2014 Oct;48(4):510-7. doi:
      10.1016/j.jpainsymman.2013.10.019. Epub 2014 Apr 14.
TY  - JOUR
AU  - Bruera, Sebastian
AU  - Chisholm, Gary
AU  - Dos Santos, Renata
AU  - Crovador, Camila
AU  - Bruera, Eduardo
AU  - Hui, David
PY  - 2014/Oct/14
TI  - Variations in vital signs in the last days of life in patients with advanced cancer.
T2  - J Pain Symptom Manage
JO  - Journal of pain and symptom management
SP  - 510
EP  - 517
VL  - 48
IS  - 4
KW  - Adolescent
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Female
KW  - Humans
KW  - Incidence
KW  - Longitudinal Studies
KW  - Male
KW  - Middle Aged
KW  - Neoplasms
KW  - Physical Examination
KW  - Prospective Studies
KW  - Reproducibility of Results
KW  - Risk Assessment
KW  - Sensitivity and Specificity
KW  - Survival
KW  - Terminal Care
KW  - Terminally Ill
KW  - Vital Signs
KW  - Young Adult
N2  - Few studies have examined variation in vital signs in the last days of life.
SN  - 1873-6513
UR  - http://dx.doi.org/10.1016/j.jpainsymman.2013.10.019
UR  - http://www.ncbi.nlm.nih.gov/pubmed/24731412
ID  - Bruera2014
ER  - 
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<b:Title>Variations in vital signs in the last days of life in patients with advanced cancer.</b:Title>
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