Several physical symptoms may signal upcoming death in advanced cancer patients, said Dr. David Hui and his colleagues in the department of palliative care and rehabilitation medicine at the University of Texas MD Anderson Cancer Center, Houston.
In a study of 357 advanced cancer patients in palliative care, 203 of whom died, eight specific symptoms were associated with death within 3 days. These physical signs were nonreactive pupils (positive likelihood ratio [LR], = 16.7), decreased response to verbal stimuli (LR, 8.3), decreased response to visual stimuli (LR, 6.7), inability to close the eyelids (LR, 13.6), drooping of the nasolabial fold (LR, 8.3), hyperextension of the neck (LR, 7.3), grunting of vocal chords (LR, 11.8), and upper gastrointestinal bleeding (LR, 10.3), the authors reported.
“The use of these bedside physical signs individually or in combination may assist clinicians in making the diagnosis of impending death,” Dr. Hui and his associates wrote.
Read the full article in Cancer at doi:10.1002/cncr.29048.