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%A Hui, David; dos Santos, Renata; Chisholm, Gary; Bansal, Swati; Silva, Thiago Buosi; Kilgore, Kelly; Crovador, Camila Souza; Yu, Xiaoying; Swartz, Michael D.; Perez-Cruz, Pedro Emilio; Leite, Raphael de Almeida; Nascimento, Maria Salete de Angelis; Reddy, Suresh; Seriaco, Fabiola; Yennu, Sriram; Paiva, Carlos Eduardo; Dev, Rony; Hall, Stacy; Fajardo, Julieta; Bruera, Eduardo
%T Clinical signs of impending death in cancer patients.
%J The oncologist, vol. 19, no. 6, pp. 681-687
%D 06/2014
%V 19
%N 6
%M eng
%B The physical signs of impending death have not been well characterized in cancer patients. A better understanding of these signs may improve the ability of clinicians to diagnose impending death. We examined the frequency and onset of 10 bedside physical signs and their diagnostic performance for impending death.
%K Death, Humans, Neoplasms, Palliative Care, Patients, Physical Examination
%P 681
%L 687
%Y 10.1634/theoncologist.2013-0457
%W PHY
%G AUTHOR
%R 2014.......19..681H

@Article{Hui2014,
author="Hui, David
and dos Santos, Renata
and Chisholm, Gary
and Bansal, Swati
and Silva, Thiago Buosi
and Kilgore, Kelly
and Crovador, Camila Souza
and Yu, Xiaoying
and Swartz, Michael D.
and Perez-Cruz, Pedro Emilio
and Leite, Raphael de Almeida
and Nascimento, Maria Salete de Angelis
and Reddy, Suresh
and Seriaco, Fabiola
and Yennu, Sriram
and Paiva, Carlos Eduardo
and Dev, Rony
and Hall, Stacy
and Fajardo, Julieta
and Bruera, Eduardo",
title="Clinical signs of impending death in cancer patients.",
journal="The oncologist",
year="2014",
month="Jun",
day="23",
volume="19",
number="6",
pages="681--687",
keywords="Death",
keywords="Humans",
keywords="Neoplasms",
keywords="Palliative Care",
keywords="Patients",
keywords="Physical Examination",
abstract="The physical signs of impending death have not been well characterized in cancer patients. A better understanding of these signs may improve the ability of clinicians to diagnose impending death. We examined the frequency and onset of 10 bedside physical signs and their diagnostic performance for impending death.",
issn="1549-490X",
doi="10.1634/theoncologist.2013-0457",
url="http://www.ncbi.nlm.nih.gov/pubmed/24760709",
language="eng"
}

%0 Journal Article
%T Clinical signs of impending death in cancer patients.
%A Hui, David
%A dos Santos, Renata
%A Chisholm, Gary
%A Bansal, Swati
%A Silva, Thiago Buosi
%A Kilgore, Kelly
%A Crovador, Camila Souza
%A Yu, Xiaoying
%A Swartz, Michael D.
%A Perez-Cruz, Pedro Emilio
%A Leite, Raphael de Almeida
%A Nascimento, Maria Salete de Angelis
%A Reddy, Suresh
%A Seriaco, Fabiola
%A Yennu, Sriram
%A Paiva, Carlos Eduardo
%A Dev, Rony
%A Hall, Stacy
%A Fajardo, Julieta
%A Bruera, Eduardo
%J The oncologist
%D 2014
%8 Jun 23
%V 19
%N 6
%@ 1549-490X
%G eng
%F Hui2014
%X The physical signs of impending death have not been well characterized in cancer patients. A better understanding of these signs may improve the ability of clinicians to diagnose impending death. We examined the frequency and onset of 10 bedside physical signs and their diagnostic performance for impending death.
%K Death
%K Humans
%K Neoplasms
%K Palliative Care
%K Patients
%K Physical Examination
%U http://dx.doi.org/10.1634/theoncologist.2013-0457
%U http://www.ncbi.nlm.nih.gov/pubmed/24760709
%P 681-687

PT Journal
AU Hui, D
   dos Santos, R
   Chisholm, G
   Bansal, S
   Silva, TB
   Kilgore, K
   Crovador, CS
   Yu, X
   Swartz, MD
   Perez-Cruz, PE
   Leite, RdA
   Nascimento, MSdA
   Reddy, S
   Seriaco, F
   Yennu, S
   Paiva, CE
   Dev, R
   Hall, S
   Fajardo, J
   Bruera, E
TI Clinical signs of impending death in cancer patients.
SO The oncologist
JI Oncologist
PD Jun
PY 2014
BP 681
EP 687
VL 19
IS 6
DI 10.1634/theoncologist.2013-0457
LA eng
DE Death; Humans; Neoplasms; Palliative Care; Patients; Physical Examination
AB The physical signs of impending death have not been well characterized in cancer patients. A better understanding of these signs may improve the ability of clinicians to diagnose impending death. We examined the frequency and onset of 10 bedside physical signs and their diagnostic performance for impending death.
ER

PMID- 24760709
OWN - NLM
STAT- MEDLINE
DA  - 20140603
DCOM- 20150212
LR  - 20150806
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Linking)
VI  - 19
IP  - 6
DP  - 2014 Jun
TI  - Clinical signs of impending death in cancer patients.
PG  - 681-7
LID - 10.1634/theoncologist.2013-0457 [doi]
AB  - BACKGROUND: The physical signs of impending death have not been well
      characterized in cancer patients. A better understanding of these signs may
      improve the ability of clinicians to diagnose impending death. We examined the
      frequency and onset of 10 bedside physical signs and their diagnostic performance
      for impending death. METHODS: We systematically documented 10 physical signs
      every 12 hours from admission to death or discharge in 357 consecutive patients
      with advanced cancer admitted to two acute palliative care units. We examined the
      frequency and median onset of each sign from death backward and calculated their 
      likelihood ratios (LRs) associated with death within 3 days. RESULTS: In total,
      203 of 357 patients (52 of 151 in the U.S., 151 of 206 in Brazil) died. Decreased
      level of consciousness, Palliative Performance Scale </=20%, and dysphagia of
      liquids appeared at high frequency and >3 days before death and had low
      specificity (<90%) and positive LR (<5) for impending death. In contrast, apnea
      periods, Cheyne-Stokes breathing, death rattle, peripheral cyanosis,
      pulselessness of radial artery, respiration with mandibular movement, and
      decreased urine output occurred mostly in the last 3 days of life and at lower
      frequency. Five of these signs had high specificity (>95%) and positive LRs for
      death within 3 days, including pulselessness of radial artery (positive LR: 15.6;
      95% confidence interval [CI]: 13.7-17.4), respiration with mandibular movement
      (positive LR: 10; 95% CI: 9.1-10.9), decreased urine output (positive LR: 15.2;
      95% CI: 13.4-17.1), Cheyne-Stokes breathing (positive LR: 12.4; 95% CI:
      10.8-13.9), and death rattle (positive LR: 9; 95% CI: 8.1-9.8). CONCLUSION: We
      identified highly specific physical signs associated with death within 3 days
      among cancer patients.
CI  - (c)AlphaMed Press.
FAU - Hui, David
AU  - Hui D
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile dhui@mdanderson.org.
FAU - dos Santos, Renata
AU  - dos Santos R
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Chisholm, Gary
AU  - Chisholm G
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Bansal, Swati
AU  - Bansal S
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Silva, Thiago Buosi
AU  - Silva TB
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Kilgore, Kelly
AU  - Kilgore K
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Crovador, Camila Souza
AU  - Crovador CS
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Yu, Xiaoying
AU  - Yu X
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Swartz, Michael D
AU  - Swartz MD
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Perez-Cruz, Pedro Emilio
AU  - Perez-Cruz PE
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Leite, Raphael de Almeida
AU  - Leite Rde A
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Nascimento, Maria Salete de Angelis
AU  - Nascimento MS
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Reddy, Suresh
AU  - Reddy S
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Seriaco, Fabiola
AU  - Seriaco F
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Yennu, Sriram
AU  - Yennu S
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Paiva, Carlos Eduardo
AU  - Paiva CE
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Dev, Rony
AU  - Dev R
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Hall, Stacy
AU  - Hall S
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Fajardo, Julieta
AU  - Fajardo J
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
FAU - Bruera, Eduardo
AU  - Bruera E
AD  - Departments of Palliative Care and Rehabilitation Medicine and Biostatistics, The
      University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of
      Palliative Care, Barretos Cancer Hospital, Barretos, Brazil; Division of
      Biostatistics, University of Texas Health Science Center at Houston, Houston,
      Texas, USA; Programa Medicina Paliativa, Facultad de Medicina, Pontificia
      Universidad Catolica de Chile, Santiago, Chile.
LA  - eng
GR  - CA 016672/CA/NCI NIH HHS/United States
GR  - P30 CA016672/CA/NCI 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  - Research Support, N.I.H., Extramural
DEP - 20140423
PL  - United States
TA  - Oncologist
JT  - The oncologist
JID - 9607837
SB  - IM
MH  - *Death
MH  - Humans
MH  - Neoplasms/diagnosis/*mortality/*pathology
MH  - Palliative Care
MH  - Patients
MH  - *Physical Examination
PMC - PMC4041673
OID - NLM: PMC4041673
OTO - NOTNLM
OT  - Death
OT  - Diagnosis
OT  - Neoplasms
OT  - Palliative care
OT  - Physical examination
OT  - Sensitivity
OT  - Signs
OT  - Specificity
EDAT- 2014/04/25 06:00
MHDA- 2015/02/13 06:00
CRDT- 2014/04/25 06:00
PHST- 2014/04/23 [aheadofprint]
AID - theoncologist.2013-0457 [pii]
AID - 10.1634/theoncologist.2013-0457 [doi]
PST - ppublish
SO  - Oncologist. 2014 Jun;19(6):681-7. doi: 10.1634/theoncologist.2013-0457. Epub 2014
      Apr 23.
TY  - JOUR
AU  - Hui, David
AU  - dos Santos, Renata
AU  - Chisholm, Gary
AU  - Bansal, Swati
AU  - Silva, Thiago Buosi
AU  - Kilgore, Kelly
AU  - Crovador, Camila Souza
AU  - Yu, Xiaoying
AU  - Swartz, Michael D.
AU  - Perez-Cruz, Pedro Emilio
AU  - Leite, Raphael de Almeida
AU  - Nascimento, Maria Salete de Angelis
AU  - Reddy, Suresh
AU  - Seriaco, Fabiola
AU  - Yennu, Sriram
AU  - Paiva, Carlos Eduardo
AU  - Dev, Rony
AU  - Hall, Stacy
AU  - Fajardo, Julieta
AU  - Bruera, Eduardo
PY  - 2014/Jun/23
TI  - Clinical signs of impending death in cancer patients.
T2  - Oncologist
JO  - The oncologist
SP  - 681
EP  - 687
VL  - 19
IS  - 6
KW  - Death
KW  - Humans
KW  - Neoplasms
KW  - Palliative Care
KW  - Patients
KW  - Physical Examination
N2  - The physical signs of impending death have not been well characterized in cancer patients. A better understanding of these signs may improve the ability of clinicians to diagnose impending death. We examined the frequency and onset of 10 bedside physical signs and their diagnostic performance for impending death.
SN  - 1549-490X
UR  - http://dx.doi.org/10.1634/theoncologist.2013-0457
UR  - http://www.ncbi.nlm.nih.gov/pubmed/24760709
ID  - Hui2014
ER  - 
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<b:Title>Clinical signs of impending death in cancer patients.</b:Title>
 <b:ShortTitle>Oncologist</b:ShortTitle>
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