1.Current State of Critical Hemorrhage during Home Palliative Care for Terminally Ill Cancer Patients
Kotaro Hashimoto ; Muneo Tanaka ; Suguru Kanno ; Junko Yano ; Yoshie Iwabuchi ; Takumi Suda ; Keiko Ikeda ; Yoshiaki Tanaka ; Junichi Tanaka ; Masao Suzuki
Palliative Care Research 2016;11(1):506-509
Purpose: This study investigated the current state of critical hemorrhage during home palliative care for terminally ill cancer patients. Methods: We conducted a retrospective medical chart review of 7 cancer patients (1.4%) who received home palliative care from our clinic and died of critical hemorrhage at home from October 2007 to December 2014. Results: Four patients were male, the mean age was 70±11 years, and underlying diseases were different. None of the patients were accompanied by medical staff at the onset of bleeding. Six patients died at home and one patient was admitted to hospital for hemostasis. Six patients had a pre-hemorrhage episode more than 24 hours before critical hemorrhage occurred from the same site. One patient was administered a hemostatic agent, hemostasis was attempted in one, and one was given sedation. Six patients wanted to die at home, and did die at home. Discussion: If terminally ill cancer patients have critical hemorrhage at home, our options are limited. The results of this study suggest the importance of hemorrhage risk assessment and advance care planning.
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