{"title":"认知障碍对呼吸系统癌症患者临终关怀的影响","authors":"Katsutoshi Ando , Ayumi Suzuki , Hiroki Yoshida","doi":"10.1016/j.resinv.2024.11.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Backgrounds</h3><div>With the aging population of Japan, an increase in patients with respiratory cancers coexisting with dementia is anticipated; however, the characteristics and terminal courses of these patients remain unclear.</div></div><div><h3>Methods</h3><div>We retrospectively assessed 142 patients with respiratory cancers receiving home health care, grouping them based on the presence of cognitive impairment and comparing their backgrounds.</div></div><div><h3>Results</h3><div>Cognitive impairment was confirmed in 38 patients (26.8%), and these individuals were older and had a higher incidence of brain metastases than those without cognitive impairment. There was no statistically significant difference in 3-month survival rates. Patients with cognitive impairment exhibited significantly lower opioid use (23.5 vs. 76.4 mg/day, p < 0.001) and lower utilization of patient-controlled analgesia (43.3% vs. 67.4%, p = 0.029).</div></div><div><h3>Discussion</h3><div>Our data reflect either milder symptoms or difficulty in accurately expressing pain or discomfort among patients with cognitive impairment, underscoring the importance of careful observation and management.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 10-12"},"PeriodicalIF":2.4000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of cognitive impairment on end-of-life care in patients with respiratory cancers\",\"authors\":\"Katsutoshi Ando , Ayumi Suzuki , Hiroki Yoshida\",\"doi\":\"10.1016/j.resinv.2024.11.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Backgrounds</h3><div>With the aging population of Japan, an increase in patients with respiratory cancers coexisting with dementia is anticipated; however, the characteristics and terminal courses of these patients remain unclear.</div></div><div><h3>Methods</h3><div>We retrospectively assessed 142 patients with respiratory cancers receiving home health care, grouping them based on the presence of cognitive impairment and comparing their backgrounds.</div></div><div><h3>Results</h3><div>Cognitive impairment was confirmed in 38 patients (26.8%), and these individuals were older and had a higher incidence of brain metastases than those without cognitive impairment. There was no statistically significant difference in 3-month survival rates. Patients with cognitive impairment exhibited significantly lower opioid use (23.5 vs. 76.4 mg/day, p < 0.001) and lower utilization of patient-controlled analgesia (43.3% vs. 67.4%, p = 0.029).</div></div><div><h3>Discussion</h3><div>Our data reflect either milder symptoms or difficulty in accurately expressing pain or discomfort among patients with cognitive impairment, underscoring the importance of careful observation and management.</div></div>\",\"PeriodicalId\":20934,\"journal\":{\"name\":\"Respiratory investigation\",\"volume\":\"63 1\",\"pages\":\"Pages 10-12\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory investigation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212534524001813\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory investigation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212534524001813","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景随着日本人口老龄化，预计呼吸系统癌症合并痴呆患者将增加；然而，这些患者的特点和终末病程尚不清楚。方法回顾性分析142例接受家庭保健的呼吸系统癌症患者，根据患者是否存在认知障碍进行分组，并比较其背景。结果38例（26.8%）患者存在认知功能障碍，且年龄较大，脑转移发生率高于无认知功能障碍的患者。3个月生存率差异无统计学意义。认知障碍患者的阿片类药物使用明显降低(23.5 vs. 76.4 mg/天，p <；0.001)，患者自控镇痛的使用率较低（43.3%对67.4%,p = 0.029）。我们的数据反映了认知障碍患者的症状较轻或难以准确表达疼痛或不适，强调了仔细观察和管理的重要性。
Impact of cognitive impairment on end-of-life care in patients with respiratory cancers
Backgrounds
With the aging population of Japan, an increase in patients with respiratory cancers coexisting with dementia is anticipated; however, the characteristics and terminal courses of these patients remain unclear.
Methods
We retrospectively assessed 142 patients with respiratory cancers receiving home health care, grouping them based on the presence of cognitive impairment and comparing their backgrounds.
Results
Cognitive impairment was confirmed in 38 patients (26.8%), and these individuals were older and had a higher incidence of brain metastases than those without cognitive impairment. There was no statistically significant difference in 3-month survival rates. Patients with cognitive impairment exhibited significantly lower opioid use (23.5 vs. 76.4 mg/day, p < 0.001) and lower utilization of patient-controlled analgesia (43.3% vs. 67.4%, p = 0.029).
Discussion
Our data reflect either milder symptoms or difficulty in accurately expressing pain or discomfort among patients with cognitive impairment, underscoring the importance of careful observation and management.
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