Frequency and Management of Hemorrhagic Malignant Wounds: A Retrospective, Single-Center, Observational Study.
J Pain Symptom Manage
; 62(1): 134-140, 2021 07.
Article
en En
| MEDLINE
| ID: mdl-33259905
ABSTRACT
CONTEXT The prevalence of bleeding episodes in malignant wounds (MW) is poorly documented, with no distinction between minor and potentially severe bleedings. This affects the quality of care. OBJECTIVES:
Assessing the frequency and management of hemorrhagic malignant wounds at Institut Curie hospital, an anti cancer center.METHODS:
Retrospective study conducted from the medical records of patients followed up by the Research and Wound Care Unit from Curie Institute (Paris, France), between 2017 and 2018. Patients >18 years of age, seen at least once by the Unit, and with an MW > 10 cm2 were included.RESULTS:
Ninety patients were included, 74.4% female and 25.6% male, with a median age of 64 years (32-92). The most frequent etiologies were breast cancer (52.2%), sarcomas (12.2%), squamous cell carcinoma ear, nose and throat (11%), and pelvic cancer (8.9%). The median survival of patients after their first consultation was 5.6 months (95% CI 4.6-8.4). Minor bleedings were observed in 38.9% of situations. Bleedings were significantly higher in malignant fungating wounds (P < 0.01). They were treated by the application of alginate or nonadherent dressings. The presence of at least one minor bleeding significantly increased the risk of more severe bleedings (P < 0.001). Hemorrhagic episodes were reported in 18.9% of patients, and 2.2% of patients died as a result of these bleeding episodes. Hemorrhages were fully controlled by hemostatic dressings in 70.6% of cases. The appearance of bleeding (minor or hemorrhagic) was significantly associated with survival (P < 0.001).CONCLUSION:
MWs with bleedings appear to be associated with a poor prognosis and could be a reason for early palliative care even if the patient's general condition is preserved. Palliative care must incorporate wound care skills to provide the most appropriate solutions to this anxiety-provoking symptom.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Heridas y Lesiones
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Enfermería de Cuidados Paliativos al Final de la Vida
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Pain Symptom Manage
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPEUTICA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
/
UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA