Miccinesi Guido, Rietjens Judith A C, Deliens Luc, Paci Eugenio, Bosshard Georg, Nilstun Tore, Norup Michael, van der Wal Gerrit
Center for Study and Prevention of Cancer, Epidemiology Unit, Florence, Italy.
J Pain Symptom Manage. 2006 Feb;31(2):122-9. doi: 10.1016/j.jpainsymman.2005.07.004.
Continuous deep sedation (CDS) is sometimes used to treat refractory symptoms in terminally ill patients. The aim of this paper was to estimate the frequency and characteristics of CDS in six European countries: Belgium, Denmark, Italy, The Netherlands, Sweden, and Switzerland. Deaths reported to death registries were sampled and the reporting doctors received a mailed questionnaire about the medical decision making that preceded the death of the patient. The total number of deaths studied was 20,480. The response rate ranged between 44% (Italy) and 75% (The Netherlands). Of all deaths, CDS was applied in 2.5% in Denmark and up to 8.5% in Italy. Of all patients receiving CDS, 35% (Italy) and up to 64% (Denmark and The Netherlands) did not receive artificial nutrition or hydration. Patients who received CDS were more often male, younger than 80 years old, more likely to have had cancer, and died more often in a hospital compared to nonsudden deaths without CDS. The high variability of frequency and characteristics of CDS in the studied European countries points out the importance of medical education and scientific debate on this issue.
持续深度镇静（CDS）有时用于治疗晚期患者的难治性症状。本文旨在评估比利时、丹麦、意大利、荷兰、瑞典和瑞士这六个欧洲国家中CDS的使用频率及特点。从向死亡登记处报告的死亡案例中抽样，向报告医生邮寄关于患者死亡前医疗决策的问卷。共研究了20480例死亡案例。回复率在44%（意大利）至75%（荷兰）之间。在所有死亡案例中，丹麦有2.5%应用了CDS，意大利则高达8.5%。在所有接受CDS的患者中，35%（意大利）至64%（丹麦和荷兰）未接受人工营养或补液。与未接受CDS的非猝死患者相比，接受CDS的患者男性居多，年龄小于80岁，患癌症的可能性更大，且更多在医院死亡。在所研究的欧洲国家中，CDS使用频率和特点的高度变异性凸显了关于此问题的医学教育和科学辩论的重要性。
