Epidemiology and Characteristics of Episodic Breathlessness in Advanced Cancer Patients: An Observational Study

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• 作者：Sebastiano Mercadante ; MD^a ; ^{terapiadeldolore@lamaddalenanet.it" class="auth_mail" title="E-mail the corresponding author} ; Federica Aielli ; MD^b ; ^e ; Claudio Adile ; MD^a ; Alessandro Valle ; MD^c ; Flavio Fusco ; MD^d ; Patrizia Ferrera ; MD^a ; Amanda Caruselli ; MD^j ; Claudio Cartoni ; MD^g ; Paolo Marchetti ; MD^h ; Giuseppe Bellavia ; MD^j ; Andrea Cortegiani ; MDⁱ ; Francesco Masedu ; PhD^f ; Marco Valenti ; PhD^f ; Giampiero Porzio ; MD^b ; ^e
• 关键词：Episodic breathlessness ; dyspnea ; advanced cancer ; palliative care ; opioids
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：51
• 期：1
• 页码：17-24
• 全文大小：133 K

文摘

Episodic breathlessness is a relevant aspect in patients with advanced cancer.

Objectives

The aim of this study was to assess the different aspects of this clinical phenomenon.

Methods

A consecutive sample of patients with advanced cancer admitted to different settings for a period of six months was surveyed. The presence of background breathlessness and episodic breathlessness, their intensity (numerical scale 0–10), and drugs used for treatment were collected. Factors inducing episodic breathlessness and its influence on daily activities were investigated.

Results

Of 921 patients, 29.3% (n = 269) had breathlessness and 134 patients (49.8%) were receiving drugs for background breathlessness. In the multivariate analysis, the risk of breathlessness increased with chronic obstructive pulmonary disease, although it decreased in patients receiving disease-oriented therapy and patients with gastrointestinal tumors. The prevalence of episodic breathlessness was 70.9% (n = 188), and its mean intensity was 7.1 (SD 1.6). The mean duration of untreated episodic breathlessness was 19.9 minutes (SD 35.3); 41% of these patients were receiving drugs for episodic breathlessness. The majority of episodic breathlessness events (88.2%) were triggered by activity. In the multivariate analysis, higher Karnofsky Performance Status levels were significantly related to episodic breathlessness, although patients receiving disease-oriented therapy were less likely to have episodic breathlessness.

Conclusion

This study showed that episodic breathlessness frequently occurs in patients with breathlessness in the advanced stage of disease, has a severe intensity, and is characterized by rapid onset and short duration, which require rapid measures.