Death is something we will all have to go through. It is something inevitable and something we should all be aware of. However, for some of us it is going to come sooner. A new UCL-led study has identified the key signs and symptoms that allow palliative care doctors to recognise when a patient is dying. Scientists say that some doctors are frequently inaccurate when predicting for how long those living with terminal illnesses will survive.
Predicting the time of death is very hard, but very important. It allows patients and their close ones to prepare for this moment, but a previous study has identify that inaccuracies in prediction range from an underestimate of 86 days to an overestimate of 93 days. Scientists wanted to find out how expert palliative care doctors predict the imminent death so they invited some professionals to participate in a study. They were presented with 20 real-life cases and were asked to decide whether the patient was close to death or not. Scientists used this research to identify the top 20% of participants who were most accurate in these predictions.
The expert palliative care doctors who were the best in their predictions then were presented with an additional 50 cases of hypothetical patients. They had to estimate the probability of death within the next 72 hours. Using this information scientists identified key signs and factors that allow these professionals predicting the time of death. Study showed that the most influential factor was the Palliative Performance Score (ranging from fully independent 100 % to needing full support and unconsciousness <10%). The second most important factor was the abnormal breathing pattern called Cheyne Stoke breathing.
Scientists say that these results could be helpful in actually making these predictions more accurate. Dr Adrian Tookman, co-author of the paper, said: “This paper reinforces that expertise and knowledge in this area is needed; we need to understand how we can help people to manage the uncertainties that can occur at this time”. Scientists hope that this study will help improving educational training materials to teach doctors, medical students and other healthcare professionals how to model their own judgement policies about the imminent death.
The question ‘how long has my loved one got?’ is a very hard to give and to hear, but everyone expects an honest and an accurate answer. It is difficult to prepare for the moment of death, but it is easier if it is expected. Studies like this could make predictions at least that little bit more accurate.