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Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study.

Abstract Five highly specific physical signs associated with death within 3 days among cancer patients were recently reported that may aid in the diagnosis of impending death. In this study, the frequency and onset of another 52 bedside physical signs and their diagnostic performance for impending death were examined.
PMID
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Authors

Mayor MeshTerms

Death

Keywords

diagnosis

neoplasms

palliative care

physical examination

sensitivity

signs

specificity

Journal Title cancer
Publication Year Start
%A Hui, David; Dos Santos, Renata; Chisholm, Gary; Bansal, Swati; Souza Crovador, Camila; Bruera, Eduardo
%T Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study.
%J Cancer, vol. 121, no. 6, pp. 960-967
%D 03/2015
%V 121
%N 6
%M eng
%B Five highly specific physical signs associated with death within 3 days among cancer patients were recently reported that may aid in the diagnosis of impending death. In this study, the frequency and onset of another 52 bedside physical signs and their diagnostic performance for impending death were examined.
%K Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Death, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neoplasms, Palliative Care, Physical Examination, Prospective Studies, Young Adult
%P 960
%L 967
%Y 10.1002/cncr.29048
%W PHY
%G AUTHOR
%R 2015CaRes.121..960H

@Article{Hui2015,
author="Hui, David
and Dos Santos, Renata
and Chisholm, Gary
and Bansal, Swati
and Souza Crovador, Camila
and Bruera, Eduardo",
title="Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study.",
journal="Cancer",
year="2015",
month="Mar",
day="15",
volume="121",
number="6",
pages="960--967",
keywords="Adolescent",
keywords="Adult",
keywords="Aged",
keywords="Aged, 80 and over",
keywords="Cohort Studies",
keywords="Death",
keywords="Female",
keywords="Humans",
keywords="Longitudinal Studies",
keywords="Male",
keywords="Middle Aged",
keywords="Neoplasms",
keywords="Palliative Care",
keywords="Physical Examination",
keywords="Prospective Studies",
keywords="Young Adult",
abstract="Five highly specific physical signs associated with death within 3 days among cancer patients were recently reported that may aid in the diagnosis of impending death. In this study, the frequency and onset of another 52 bedside physical signs and their diagnostic performance for impending death were examined.",
issn="1097-0142",
doi="10.1002/cncr.29048",
url="http://www.ncbi.nlm.nih.gov/pubmed/25676895",
language="eng"
}

%0 Journal Article
%T Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study.
%A Hui, David
%A Dos Santos, Renata
%A Chisholm, Gary
%A Bansal, Swati
%A Souza Crovador, Camila
%A Bruera, Eduardo
%J Cancer
%D 2015
%8 Mar 15
%V 121
%N 6
%@ 1097-0142
%G eng
%F Hui2015
%X Five highly specific physical signs associated with death within 3 days among cancer patients were recently reported that may aid in the diagnosis of impending death. In this study, the frequency and onset of another 52 bedside physical signs and their diagnostic performance for impending death were examined.
%K Adolescent
%K Adult
%K Aged
%K Aged, 80 and over
%K Cohort Studies
%K Death
%K Female
%K Humans
%K Longitudinal Studies
%K Male
%K Middle Aged
%K Neoplasms
%K Palliative Care
%K Physical Examination
%K Prospective Studies
%K Young Adult
%U http://dx.doi.org/10.1002/cncr.29048
%U http://www.ncbi.nlm.nih.gov/pubmed/25676895
%P 960-967

PT Journal
AU Hui, D
   Dos Santos, R
   Chisholm, G
   Bansal, S
   Souza Crovador, C
   Bruera, E
TI Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study.
SO Cancer
PD Mar
PY 2015
BP 960
EP 967
VL 121
IS 6
DI 10.1002/cncr.29048
LA eng
DE Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Death; Female; Humans; Longitudinal Studies; Male; Middle Aged; Neoplasms; Palliative Care; Physical Examination; Prospective Studies; Young Adult
AB Five highly specific physical signs associated with death within 3 days among cancer patients were recently reported that may aid in the diagnosis of impending death. In this study, the frequency and onset of another 52 bedside physical signs and their diagnostic performance for impending death were examined.
ER

PMID- 25676895
OWN - NLM
STAT- MEDLINE
DA  - 20150305
DCOM- 20150508
LR  - 20160415
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Linking)
VI  - 121
IP  - 6
DP  - 2015 Mar 15
TI  - Bedside clinical signs associated with impending death in patients with advanced 
      cancer: preliminary findings of a prospective, longitudinal cohort study.
PG  - 960-7
LID - 10.1002/cncr.29048 [doi]
AB  - BACKGROUND: Five highly specific physical signs associated with death within 3
      days among cancer patients were recently reported that may aid in the diagnosis
      of impending death. In this study, the frequency and onset of another 52 bedside 
      physical signs and their diagnostic performance for impending death were
      examined. METHODS: Three hundred fifty-seven consecutive patients with advanced
      cancer who had been admitted to acute palliative care units at 2 tertiary care
      cancer centers were enrolled. Fifty-two physical signs were systematically
      documented every 12 hours from admission to death or discharge. The frequency and
      median time of onset of each sign from death backwards were examined, and the
      likelihood ratios (LRs) associated with death within 3 days were calculated.
      RESULTS: Two hundred three of the 357 patients (57%) died at the end of the
      admission. Eight physical signs that were highly diagnostic of impending death
      were identified. These signs occurred in 5% to 78% of the patients within the
      last 3 days of life, had a late onset, and had a high specificity (>95%) and a
      high positive LR for death within 3 days. They included nonreactive pupils
      (positive LR, 16.7; 95% confidence interval [CI], 14.9-18.6), a decreased
      response to verbal stimuli (positive LR, 8.3; 95% CI, 7.7-9), a decreased
      response to visual stimuli (positive LR, 6.7; 95% CI, 6.3-7.1), an inability to
      close eyelids (positive LR, 13.6; 95% CI, 11.7-15.5), drooping of the nasolabial 
      fold (positive LR, 8.3; 95% CI, 7.7-8.9), hyperextension of the neck (positive
      LR, 7.3; 95% CI, 6.7-8), grunting of vocal cords (positive LR, 11.8; 95% CI,
      10.3-13.4), and upper gastrointestinal bleeding (positive LR, 10.3; 95% CI,
      9.5-11.1). CONCLUSIONS: Eight highly specific physical signs associated with
      death within 3 days among cancer patients were identified. These signs may inform
      the diagnosis of impending death.
CI  - (c) 2015 American Cancer Society.
FAU - Hui, David
AU  - Hui D
AD  - Department of Palliative Care and Rehabilitation Medicine, University of Texas MD
      Anderson Cancer Center, Houston, Texas.
FAU - Dos Santos, Renata
AU  - Dos Santos R
FAU - Chisholm, Gary
AU  - Chisholm G
FAU - Bansal, Swati
AU  - Bansal S
FAU - Souza Crovador, Camila
AU  - Souza Crovador C
FAU - Bruera, Eduardo
AU  - Bruera E
LA  - eng
GR  - CA016672/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
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20150209
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
SB  - AIM
SB  - IM
CIN - BMJ. 2015;350:h663. PMID: 25667549
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - *Death
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*physiopathology/therapy
MH  - Palliative Care
MH  - Physical Examination
MH  - Prospective Studies
MH  - Young Adult
PMC - PMC4352117
MID - NIHMS631436
OID - NLM: NIHMS631436
OID - NLM: PMC4352117
OTO - NOTNLM
OT  - diagnosis
OT  - neoplasms
OT  - palliative care
OT  - physical examination
OT  - sensitivity
OT  - signs
OT  - specificity
EDAT- 2015/02/14 06:00
MHDA- 2015/05/09 06:00
CRDT- 2015/02/14 06:00
PHST- 2014/04/22 [received]
PHST- 2014/07/03 [revised]
PHST- 2014/08/15 [accepted]
PHST- 2015/02/09 [aheadofprint]
AID - 10.1002/cncr.29048 [doi]
PST - ppublish
SO  - Cancer. 2015 Mar 15;121(6):960-7. doi: 10.1002/cncr.29048. Epub 2015 Feb 9.
TY  - JOUR
AU  - Hui, David
AU  - Dos Santos, Renata
AU  - Chisholm, Gary
AU  - Bansal, Swati
AU  - Souza Crovador, Camila
AU  - Bruera, Eduardo
PY  - 2015/Mar/15
TI  - Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study.
JO  - Cancer
SP  - 960
EP  - 967
VL  - 121
IS  - 6
KW  - Adolescent
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Cohort Studies
KW  - Death
KW  - Female
KW  - Humans
KW  - Longitudinal Studies
KW  - Male
KW  - Middle Aged
KW  - Neoplasms
KW  - Palliative Care
KW  - Physical Examination
KW  - Prospective Studies
KW  - Young Adult
N2  - Five highly specific physical signs associated with death within 3 days among cancer patients were recently reported that may aid in the diagnosis of impending death. In this study, the frequency and onset of another 52 bedside physical signs and their diagnostic performance for impending death were examined.
SN  - 1097-0142
UR  - http://dx.doi.org/10.1002/cncr.29048
UR  - http://www.ncbi.nlm.nih.gov/pubmed/25676895
ID  - Hui2015
ER  - 
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