Paracentesis for cancer-related ascites in palliative care : An international, prospective cohort study
BACKGROUND: Paracentesis is commonly undertaken in patients with cancer-related ascites.
AIM: To systematically investigate the symptomatic benefits and harms experienced by patients with cancer undergoing paracentesis using real-world data in the palliative care setting.
DESIGN: Prospective, multisite, observational, consecutive cohort study. Benefits and harms of paracentesis were assessed between 01/07/2018 and 31/02/2021 as part of routine clinical assessments by treating clinicians at four timepoints: (T0) before paracentesis; (T1) once drainage ceased; (T2) 24 h after T1 and (T3) 28 days after T1 or next paracentesis, if sooner.
SETTING/PARTICIPANTS: Data were collected from 11 participating sites across five countries (Australia, England, Hong Kong, Malaysia and New Zealand) on 111 patients undergoing paracentesis via a temporary (73%) or indwelling (21%) catheter: 51% male, median age 69 years, Australia-modified Karnofsky Performance Score 50.
RESULTS: At T1 (n = 100), symptoms had improved for most patients (81%), specifically abdominal distension (61%), abdominal pain (49%) and nausea (27%), with two-thirds experiencing improvement in ⩾2 symptoms. In the remaining patients, symptoms were unchanged (7%) or worse (12%). At least one harm occurred in 32% of patients, the most common being an ascitic leak (n = 14). By T3, 89% of patients had experienced some benefit and 36% some harm, including four patients who experienced serious harm, one of which was a fatal bowel perforation.
CONCLUSION: Most patients obtained rapid benefits from paracentesis. Harms were less frequent and generally mild, but occasionally serious and fatal. Our findings help inform clinician-patient discussions about the potential outcomes of paracentesis in this frail population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Palliative medicine - 36(2022), 9 vom: 27. Okt., Seite 1408-1417 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Seah, Davinia Se [VerfasserIn] |
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| Links: |
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| Themen: |
Ascites |
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| Anmerkungen: |
Date Completed 24.10.2022 Date Revised 01.11.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/02692163221122326 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM346298733 |
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| 100 | 1 | |a Seah, Davinia Se |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Paracentesis for cancer-related ascites in palliative care |b An international, prospective cohort study |
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| 500 | |a Date Revised 01.11.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Paracentesis is commonly undertaken in patients with cancer-related ascites | ||
| 520 | |a AIM: To systematically investigate the symptomatic benefits and harms experienced by patients with cancer undergoing paracentesis using real-world data in the palliative care setting | ||
| 520 | |a DESIGN: Prospective, multisite, observational, consecutive cohort study. Benefits and harms of paracentesis were assessed between 01/07/2018 and 31/02/2021 as part of routine clinical assessments by treating clinicians at four timepoints: (T0) before paracentesis; (T1) once drainage ceased; (T2) 24 h after T1 and (T3) 28 days after T1 or next paracentesis, if sooner | ||
| 520 | |a SETTING/PARTICIPANTS: Data were collected from 11 participating sites across five countries (Australia, England, Hong Kong, Malaysia and New Zealand) on 111 patients undergoing paracentesis via a temporary (73%) or indwelling (21%) catheter: 51% male, median age 69 years, Australia-modified Karnofsky Performance Score 50 | ||
| 520 | |a RESULTS: At T1 (n = 100), symptoms had improved for most patients (81%), specifically abdominal distension (61%), abdominal pain (49%) and nausea (27%), with two-thirds experiencing improvement in ⩾2 symptoms. In the remaining patients, symptoms were unchanged (7%) or worse (12%). At least one harm occurred in 32% of patients, the most common being an ascitic leak (n = 14). By T3, 89% of patients had experienced some benefit and 36% some harm, including four patients who experienced serious harm, one of which was a fatal bowel perforation | ||
| 520 | |a CONCLUSION: Most patients obtained rapid benefits from paracentesis. Harms were less frequent and generally mild, but occasionally serious and fatal. Our findings help inform clinician-patient discussions about the potential outcomes of paracentesis in this frail population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Ascites | |
| 650 | 4 | |a drainage | |
| 650 | 4 | |a neoplasms | |
| 650 | 4 | |a palliative care | |
| 650 | 4 | |a paracentesis | |
| 700 | 1 | |a Wilcock, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Sungwon |e verfasserin |4 aut | |
| 700 | 1 | |a Sousa, Mariana S |e verfasserin |4 aut | |
| 700 | 1 | |a Sinnarajah, Aynharan |e verfasserin |4 aut | |
| 700 | 1 | |a Teoh, Cy Oun |e verfasserin |4 aut | |
| 700 | 1 | |a Allan, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Chye, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Doogue, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Hunt, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Agar, Meera |e verfasserin |4 aut | |
| 700 | 1 | |a Currow, David C |e verfasserin |4 aut | |
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