The Effects of the Pleural Interventions on Patients' Performance Status, Dyspnea, and Pain Scores in Patients Receiving Palliative Care

Document Type : Original Article

Author

1 Division of Palliative Care Unit, Chief physician, Kars Harakani State Hospital, Kars, Turkey.

2 Department of Thoracic Surgery, Kars Harakani State Hospital, Kars, Turkey.

Abstract

Instruction : Palliative care units aim to improve the quality of life and alleviate symptoms in patients with serious illnesses. Dyspnea, a distressing symptom, can significantly impact patients' quality of life. While various methods are used to manage dyspnea in palliative patients, surgical interventions may be overlooked or underutilized due to patient-specific considerations. This study investigates the effects of pleural interventions on quality of life, dyspnea, and pain scores in palliative care patients.
Materials and Methods : This retrospective case series analyzed data from 213 patients treated in a palliative care service between May 2022 and May 2023. Patients who underwent pleural interventions for dyspnea control were included. Data on patient characteristics, pleural pathologies, type of intervention (thoracentesis, indwelling pleural catheter or tube thoracostomy), complications, modified Borg dyspnea scale, Karnofsky Performance Scale (KPS), and visual analog scale (VAS) scores were collected.
Results : A total of 21 patients met the inclusion criteria. Thoracentesis was the most commonly performed intervention. After pleural intervention, Borg dyspnea scale scores significantly decreased (5.9-3.2, p<0.001), while KPS scores significantly increased (32.4-40.9, p<0.001). No significant difference was observed in VAS scores (3.1-3.4, p:0.25). Complications were minimal, with a small number of patients experiencing iatrogenic pneumothorax or catheter infection.
Conclusions :This study highlights the importance of pleural interventions in managing dyspnea and improving symptom control-related performance in palliative care patients. Therapeutic thoracentesis, pleural catheter insertion, and chest tube placement have demonstrated effectiveness in alleviating dyspnea. Therefore, pleural interventions should not be avoided if indicated in palliative care patients accompanied by dyspnea. However, potential complications and limitations must be considered, and patient-specific factors should guide decision-making.

Keywords

References

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Journal of Cardio-Thoracic Medicine
Volume 11, Issue 3
September 2023
Pages 1192-1198

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