The Volume of Hydration in Terminally Ill Cancer Patients with Hydration-Related Symptoms: A Prospective Study

Nobuhisa Nakajima, MD, PhD, Yuji Takahashi, MD, PhD, and Kunihiko Ishitani, MD, PhD

Department of Palliative Care, Higashi Sapporo Hospital, Sapporo, Japan.

Address correspondence to:

Nobuhisa Nakajima, MD, PhD

Division of Palliative Care

Asahikawa Medical University Hospital

2-1-1-1, Midorigaoka-higashi

Asahikawa

Hokkaido 078-8510

Japan
E-mail: nakajy@dream.ocn.ne.jp

Accepted May 12, 2014

ABSTRACT

Background: Recently, there has been a growing interest in the use of artificial hydration therapy (AHT) for terminally ill cancer patients. Some studies have demonstrated that appropriate hydration can contribute to patient comfort; however, few studies have examined the effects of volume reduction on patient symptoms and quality of life (QOL).

Objective: This study aimed to clarify the effects of reducing the volume of artificial hydration based on the Japanese guideline in terminally ill cancer patients with hydration-related symptoms on the alleviation of various symptoms and QOL.

Methods: Of the 273 terminally ill cancer patients who were transferred from other hospitals for palliative care over the last 2 years, 78 patients who presented with hydration-related symptoms at the time of admission were analyzed. We performed guideline-based AHT and reduced the volume of hydration with standard pharmacological therapy. The effects on the alleviation of hydration-related symptoms and QOL were examined using a numeric rating scale and item 30 of the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30 (EORTC QLQ-C30) to compare values measured before and one week after AHT. We also evaluated patient satisfaction and the feeling of benefit from hydration one week after the study commenced.

Results: Hydration-related symptoms (nausea, 16 cases; abdominal pain/distention, 22 cases; peripheral edema, 32 cases; and dyspnea, 15 cases) were significantly improved after performing guideline-based AHT (p=0.024, p=0.003, p<0.0001, and p=0.046, respectively). General QOL scores, global satisfaction, and feeling of benefit were also significantly improved after performing guideline-based AHT (p<0.0001, p=0.0001, and p=0.001, respectively).

Conclusions: The provision of appropriate guideline-based AHT can contribute to alleviating hydration-related symptoms and improving QOL in terminally ill cancer patients.