Prevalence and associated factors of orphan symptoms in advanced cancer patients: a multicenter observational study

Purpose The aims of this study were to examine the prevalence of myoclonus, sweating, pruritus, hiccup, and vesical and rectal tenesmus, and to explore associated factors in patients with advanced cancer. Methods This multicenter prospective cohort study was conducted in 23 inpatient hospices/pallia...

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Veröffentlicht in:Supportive care in cancer 2021-09, Vol.29 (9), p.5537-5547
Hauptverfasser: Nishijima, Kaoru, Kizawa, Yoshiyuki, Yamauchi, Toshihiro, Odagiri, Takuya, Ito, Tetsuya, Kaneishi, Keisuke, Shimizu, Keiji, Morita, Tatsuya, Mori, Masanori
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container_end_page 5547
container_issue 9
container_start_page 5537
container_title Supportive care in cancer
container_volume 29
creator Nishijima, Kaoru
Kizawa, Yoshiyuki
Yamauchi, Toshihiro
Odagiri, Takuya
Ito, Tetsuya
Kaneishi, Keisuke
Shimizu, Keiji
Morita, Tatsuya
Mori, Masanori
description Purpose The aims of this study were to examine the prevalence of myoclonus, sweating, pruritus, hiccup, and vesical and rectal tenesmus, and to explore associated factors in patients with advanced cancer. Methods This multicenter prospective cohort study was conducted in 23 inpatient hospices/palliative care units in Japan from January to December 2017. The prevalence and characteristics of each symptom were assessed on admission and in the 3 days before death. We selected factors that might influence the occurrence of each symptom and investigated the association. Results A total of 1896 patients were enrolled. The prevalence of orphan symptoms rose from admission to the 3 days before death: myoclonus 1.3 to 5.3% (95% CI 0.9–1.9%/4.3–6.5%), sweating 1.8 to 4.1% (95% CI 1.3–2.6%/3.1–5.1%), hiccup 1.1 to 1.8% (95% CI 0.7–1.7%/1.2–2.6%), and tenesmus 0.7 to 0.9% (0.4–1.2%/0.5–1.5%). Prevalence of pruritus fell from 3.5 to 2.5% (95% CI 2.7–4.4%/1.8–3.4%). Sweating, pruritus, and hiccups persisted throughout the day in nearly half of the patients. Myoclonus was significantly associated with brain tumors, sweating with opioids and antipsychotics, pruritus with liver and biliary tract cancer, cholestasis and severe diabetes, hiccup with male gender, digestive tract obstruction, severe diabetes, and renal failure. Vesical tenesmus was associated with urinary cancer, antipsychotics, and anticholinergics and rectal tenesmus with pelvic cavity cancer. Conclusion We found that orphan symptoms occurred in 0.5–5.0% of patients, increased over time except for pruritus, and persisted in half of the patients.
doi_str_mv 10.1007/s00520-021-06144-6
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Methods This multicenter prospective cohort study was conducted in 23 inpatient hospices/palliative care units in Japan from January to December 2017. The prevalence and characteristics of each symptom were assessed on admission and in the 3 days before death. We selected factors that might influence the occurrence of each symptom and investigated the association. Results A total of 1896 patients were enrolled. The prevalence of orphan symptoms rose from admission to the 3 days before death: myoclonus 1.3 to 5.3% (95% CI 0.9–1.9%/4.3–6.5%), sweating 1.8 to 4.1% (95% CI 1.3–2.6%/3.1–5.1%), hiccup 1.1 to 1.8% (95% CI 0.7–1.7%/1.2–2.6%), and tenesmus 0.7 to 0.9% (0.4–1.2%/0.5–1.5%). Prevalence of pruritus fell from 3.5 to 2.5% (95% CI 2.7–4.4%/1.8–3.4%). Sweating, pruritus, and hiccups persisted throughout the day in nearly half of the patients. Myoclonus was significantly associated with brain tumors, sweating with opioids and antipsychotics, pruritus with liver and biliary tract cancer, cholestasis and severe diabetes, hiccup with male gender, digestive tract obstruction, severe diabetes, and renal failure. Vesical tenesmus was associated with urinary cancer, antipsychotics, and anticholinergics and rectal tenesmus with pelvic cavity cancer. Conclusion We found that orphan symptoms occurred in 0.5–5.0% of patients, increased over time except for pruritus, and persisted in half of the patients.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-021-06144-6</identifier><identifier>PMID: 33725175</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Antipsychotic drugs ; Brain tumors ; Cancer ; Cancer patients ; Care and treatment ; Diabetes ; Medicine ; Medicine &amp; Public Health ; Nursing ; Nursing Research ; Observational studies ; Oncology ; Oncology, Experimental ; Original Article ; Pain Medicine ; Palliative care ; Pruritus ; Psychotropic drugs ; Rehabilitation Medicine ; Sweating</subject><ispartof>Supportive care in cancer, 2021-09, Vol.29 (9), p.5537-5547</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c570t-df79cd27b4007487d99e742162054defec09a822118560a3a2b29c1375750c033</citedby><cites>FETCH-LOGICAL-c570t-df79cd27b4007487d99e742162054defec09a822118560a3a2b29c1375750c033</cites><orcidid>0000-0002-9568-3654</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-021-06144-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-021-06144-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33725175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nishijima, Kaoru</creatorcontrib><creatorcontrib>Kizawa, Yoshiyuki</creatorcontrib><creatorcontrib>Yamauchi, Toshihiro</creatorcontrib><creatorcontrib>Odagiri, Takuya</creatorcontrib><creatorcontrib>Ito, Tetsuya</creatorcontrib><creatorcontrib>Kaneishi, Keisuke</creatorcontrib><creatorcontrib>Shimizu, Keiji</creatorcontrib><creatorcontrib>Morita, Tatsuya</creatorcontrib><creatorcontrib>Mori, Masanori</creatorcontrib><title>Prevalence and associated factors of orphan symptoms in advanced cancer patients: a multicenter observational study</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Purpose The aims of this study were to examine the prevalence of myoclonus, sweating, pruritus, hiccup, and vesical and rectal tenesmus, and to explore associated factors in patients with advanced cancer. Methods This multicenter prospective cohort study was conducted in 23 inpatient hospices/palliative care units in Japan from January to December 2017. The prevalence and characteristics of each symptom were assessed on admission and in the 3 days before death. We selected factors that might influence the occurrence of each symptom and investigated the association. Results A total of 1896 patients were enrolled. The prevalence of orphan symptoms rose from admission to the 3 days before death: myoclonus 1.3 to 5.3% (95% CI 0.9–1.9%/4.3–6.5%), sweating 1.8 to 4.1% (95% CI 1.3–2.6%/3.1–5.1%), hiccup 1.1 to 1.8% (95% CI 0.7–1.7%/1.2–2.6%), and tenesmus 0.7 to 0.9% (0.4–1.2%/0.5–1.5%). Prevalence of pruritus fell from 3.5 to 2.5% (95% CI 2.7–4.4%/1.8–3.4%). Sweating, pruritus, and hiccups persisted throughout the day in nearly half of the patients. Myoclonus was significantly associated with brain tumors, sweating with opioids and antipsychotics, pruritus with liver and biliary tract cancer, cholestasis and severe diabetes, hiccup with male gender, digestive tract obstruction, severe diabetes, and renal failure. Vesical tenesmus was associated with urinary cancer, antipsychotics, and anticholinergics and rectal tenesmus with pelvic cavity cancer. 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Methods This multicenter prospective cohort study was conducted in 23 inpatient hospices/palliative care units in Japan from January to December 2017. The prevalence and characteristics of each symptom were assessed on admission and in the 3 days before death. We selected factors that might influence the occurrence of each symptom and investigated the association. Results A total of 1896 patients were enrolled. The prevalence of orphan symptoms rose from admission to the 3 days before death: myoclonus 1.3 to 5.3% (95% CI 0.9–1.9%/4.3–6.5%), sweating 1.8 to 4.1% (95% CI 1.3–2.6%/3.1–5.1%), hiccup 1.1 to 1.8% (95% CI 0.7–1.7%/1.2–2.6%), and tenesmus 0.7 to 0.9% (0.4–1.2%/0.5–1.5%). Prevalence of pruritus fell from 3.5 to 2.5% (95% CI 2.7–4.4%/1.8–3.4%). Sweating, pruritus, and hiccups persisted throughout the day in nearly half of the patients. Myoclonus was significantly associated with brain tumors, sweating with opioids and antipsychotics, pruritus with liver and biliary tract cancer, cholestasis and severe diabetes, hiccup with male gender, digestive tract obstruction, severe diabetes, and renal failure. Vesical tenesmus was associated with urinary cancer, antipsychotics, and anticholinergics and rectal tenesmus with pelvic cavity cancer. Conclusion We found that orphan symptoms occurred in 0.5–5.0% of patients, increased over time except for pruritus, and persisted in half of the patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33725175</pmid><doi>10.1007/s00520-021-06144-6</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-9568-3654</orcidid><oa>free_for_read</oa></addata></record>
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subjects Antipsychotic drugs
Brain tumors
Cancer
Cancer patients
Care and treatment
Diabetes
Medicine
Medicine & Public Health
Nursing
Nursing Research
Observational studies
Oncology
Oncology, Experimental
Original Article
Pain Medicine
Palliative care
Pruritus
Psychotropic drugs
Rehabilitation Medicine
Sweating
title Prevalence and associated factors of orphan symptoms in advanced cancer patients: a multicenter observational study
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