Anatomopathological Causes of Death in Patients with Advanced Cancer: Association with the Use of Anticoagulation and Antibiotics at the End of Life

Pautex, Sophie; Vayne-Bossert, Petra; Jamme, Sharon; Herrmann, Françoís; Vilarino, Raquel; Weber, Catherine; Burkhardt, Karim

doi:10.1089/jpm.2012.0369

Cited by 12 publications

(9 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With regards to PCU, a retrospective analysis at Genevan PCU showed that TPX was used in 43% of cancer patients [18]. Likewise, the TPX prevalence was high (44%) in a French study, which enrolled 1199 PCU patients, 91% of whom were cancer patients [19].…”

Section: Prevalence Of Thromboprophylaxis In Hospices and Palliative mentioning

confidence: 99%

Thromboprophylaxis in the End-of-Life Cancer Care: The Update

Zabrocka

Sierko

2020

Cancers

View full text Add to dashboard Cite

Cancer patients are at increased risk for venous thromboembolism (VTE), which further increases with advanced stages of malignancy, prolonged immobilization, or prior history of thrombosis. To reduce VTE-related mortality, many official guidelines encourage the use of thromboprophylaxis (TPX) in cancer patients in certain situations, e.g., during chemotherapy or in the perioperative period. TPX in the end-of-life care, however, remains controversial. Most recommendations on VTE prophylaxis in cancer patients are based on the outcomes of clinical trials that excluded patients under palliative or hospice care. This translates to the paucity of official guidelines on TPX dedicated to this group of patients. The problem should not be underestimated as VTE is known to be associated with symptoms adversely impacting the quality of life (QoL), i.e., limb or chest pain, dyspnea, hemoptysis. In end-of-life care, where the assurance of the best possible QoL should be the highest priority, VTE prophylaxis may eliminate the symptom burden related to thrombosis. However, large randomized studies determining the benefits and risks profiles of TPX in patients nearing the end of life are lacking. This review summarized available data on TPX in this population, analyzed potential tools for VTE risk prediction in the view of this group of patients, and summarized the most current recommendations on TPX pertaining to terminal care.

show abstract

Section: Prevalence Of Thromboprophylaxis In Hospices and Palliative mentioning

confidence: 99%

Thromboprophylaxis in the End-of-Life Cancer Care: The Update

Zabrocka

Sierko

2020

Cancers

View full text Add to dashboard Cite

show abstract

“…Many studies reported a high prevalence of thromboprophylaxis use in palliative care units in Switzerland, 36 France, 37 Canada, 3 and Austria 38 ranging from 42% to 49% which is similar to non‐cancer patients, 38 although the high tendency for discontinuation within 72 h of admission 3,36–38 . On the other hand, other studies reported much lower use of thromboprophylaxis (<7%) 21,35,39 .…”

Section: Discussionmentioning

confidence: 99%

Thromboprophylaxis for inpatient with advanced cancer receiving palliative care: A retrospective study

Al-Ansari

Abd‐El‐Gawad

AboSerea

et al. 2022

European J of Haematology

View full text Add to dashboard Cite

Objectives The benefits and risks of thromboprophylaxis usage in patients with advanced cancer at the end of their lives remain unknown, especially with the lack of randomized studies. This study aimed to describe the clinical use of thromboprophylaxis in those patients under palliative care. Methods A retrospective cohort study. It was performed on patients admitted to the Palliative Care Center. Results A total of 719 patients were enrolled in the study. The mean age was 62.97 (13.65) years. Venous thromboembolism (VTE) incidence was 5.4% (n = 39). At the time of admission, 31.29% (n = 225) of patients were on thromboprophylaxis. At death time, 17.5% (n = 126) of patients were on thromboprophylaxis (41.3% on primary and 58.7% on secondary thromboprophylaxis). The incidence of clinically suspected fatal VTE was 6.5% (n = 47). Surprisingly, clinically suspected VTE was higher statistically in patients with thromboprophylaxis rather than in non‐thromboprophylaxis (p < .001). By using linear regression, only higher PPI scores on admission were independent negative predictors of length of stay (OR:4.429, 95% CI: 5.460–3.398, p < .001). The development of clinically suspected fatal VTE, whatever the status of thromboprophylaxis, did not affect the length of stay. Conclusions Thromboprophylaxis does not decrease the risk of clinically suspected fatal VTE in patients with advanced disease in their terminal phase. Patients with poor performance status and a short prognosis are unlikely to benefit from thromboprophylaxis.

show abstract

“…Measurable parameters in the blood suggest a systemic inflammatory response including: elevated CRP, IL-6 and other pro-inflammatory cytokines, hypoalbuminaemia, leucocytosis and neutrophilia. Interestingly, post-mortem studies demonstrated evidence of silent pneumonia in advanced cancer [80,81]. Although it is not possible to assume causation, these findings are of clinical and research interest.…”

Section: Discussionmentioning

confidence: 99%

A systematically structured review of biomarkers of dying in cancer patients in the last months of life; An exploration of the biology of dying

et al. 2017

View full text Add to dashboard Cite

BackgroundThe Neuberger review made a number of recommendations to improve end of life care, including research into the biology of dying. An important aspect of the biology of dying is the identification of biomarkers as indices of disease processes. Biomarkers have the potential to inform the current, limited understanding of the dying process and assist clinicians in recognising dying, in particular how to distinguish dying from reversible acute deterioration.ObjectivesTo critically appraise the literature on biological factors that may be used as prognostic indicators in advanced cancer patients and to identify candidate biomarkers of the dying process that can be measured serially in cancer patients’ bodily fluids.MethodsA systematically structured review was conducted using three electronic databases. A hand search of six peer-reviewed journals and conference abstracts was also conducted. Studies reporting prognostic biomarkers in cancer patients with a median survival of ≤90 days and post-mortem studies were included. Final levels of evidence and recommendations were made using the Evidence Based Medicine modified GRADE system.Results30 articles were included. Seven prognostic biological factors demonstrated Grade A evidence (lymphocyte count, white blood cell count, serum C-reactive protein, albumin, sodium, urea and alkaline phosphatase). An additional eleven prognostic factors were identified with Grade B evidence (platelet count, international normalised ratio, serum vitamin B12, prealbumin, bilirubin, cholesterol, aspartate aminotransferase, alanine transaminase, lactate dehydrogenase, pseudocholinesterase and urate). A number of biomarkers were specifically identified in the last two weeks of life but limitations exist. No post-mortem studies met the inclusion criteria.ConclusionThe biology of dying is an important area for future research, with the evidence focused on signs, symptoms and prognostic factors. This review identifies a number of common themes shared amongst advanced cancer patients and highlights candidate biomarkers which may be indicative of a common biological process to dying.

show abstract

Anatomopathological Causes of Death in Patients with Advanced Cancer: Association with the Use of Anticoagulation and Antibiotics at the End of Life

Cited by 12 publications

References 30 publications

Thromboprophylaxis in the End-of-Life Cancer Care: The Update

Thromboprophylaxis in the End-of-Life Cancer Care: The Update

Thromboprophylaxis for inpatient with advanced cancer receiving palliative care: A retrospective study

A systematically structured review of biomarkers of dying in cancer patients in the last months of life; An exploration of the biology of dying

Contact Info

Product

Resources

About