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Purpose <p>This study examined the implementation status of continuous sedation (CS) and its clinical and social background factors in adolescent and young adult (AYA) patients with cancer who received end-of-life care at home.</p> Methods <p>We conducted a single-center retrospective observational study with 62 AYA patients with cancer. We compared the CS (S) and non-sedation (NS) groups, analyzing factors contributing to sedation implementation.</p> Results <p>CS implementation rate was 37.1% (23/62 cases). Participants’ median age was 36 (S group) and 33 (NS group) years (<i>p</i> = 0.08). Both groups had similar median time from initial home consultation to death (30 vs. 34&#xa0;days, resp., <i>p</i> = 0.6). Midazolam was the most frequently used sedative agent (82.6%), administered at a median of 20&#xa0;mg/day. Delirium occurred significantly more frequently in the S (vs. NS) group (60.9% vs. 23.1%, <i>p</i> = 0.006). Primary indications for sedation were dyspnea (47.8%), pain (26.1%), and delirium (17.4%). The S (vs. NS) group had significantly higher morphine equivalent doses (median 120 vs. 60&#xa0;mg, <i>p</i> = 0.0008) and higher rates of patient-controlled analgesia implementation (56.5% vs. 20.5%, <i>p</i> = 0.0056). Cases where spouses were primary decision-makers were more frequent in the S (vs. NS) group (60.9% vs. 30.8%, <i>p</i> = 0.033).</p> Conclusion <p>This descriptive analysis revealed lower CS rates among patients aged &lt; 30&#xa0;years. Sedation was not associated with shortened survival. Dyspnea was the most common sedation indication, with high-dose opioid use, delirium incidence, and spousal decision-making as primary factors associated with sedation administration. Given the small sample size and retrospective design, findings should be interpreted as exploratory.&#xa0;</p>

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Continuous sedation in adolescent and young adult cancer patients under home-based end-of-life care

  • 期刊论文

  • 发表日期：

    2026年2月13日

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  • Hirofumi Watanabe,
  • Akifumi Watanabe,
  • Koichi Fujikawa,
  • Mitsuru Furuya,
  • Hiroaki Goto,
  • Ayaka Ishikawa,
  • Kazuki Yokoyama,
  • Chihiro Seki,
  • Akiko Iida,
  • Yoriko Kosugi,
  • Yumiko Kumagai,
  • Akiko Murakami,
  • Eri Sakuma,
  • Kei Takagi,
  • Junya Kawauchi,
  • Yasuaki Gyoda,
  • Junko Watanabe

摘要

Purpose

This study examined the implementation status of continuous sedation (CS) and its clinical and social background factors in adolescent and young adult (AYA) patients with cancer who received end-of-life care at home.

Methods

We conducted a single-center retrospective observational study with 62 AYA patients with cancer. We compared the CS (S) and non-sedation (NS) groups, analyzing factors contributing to sedation implementation.

Results

CS implementation rate was 37.1% (23/62 cases). Participants’ median age was 36 (S group) and 33 (NS group) years (p = 0.08). Both groups had similar median time from initial home consultation to death (30 vs. 34 days, resp., p = 0.6). Midazolam was the most frequently used sedative agent (82.6%), administered at a median of 20 mg/day. Delirium occurred significantly more frequently in the S (vs. NS) group (60.9% vs. 23.1%, p = 0.006). Primary indications for sedation were dyspnea (47.8%), pain (26.1%), and delirium (17.4%). The S (vs. NS) group had significantly higher morphine equivalent doses (median 120 vs. 60 mg, p = 0.0008) and higher rates of patient-controlled analgesia implementation (56.5% vs. 20.5%, p = 0.0056). Cases where spouses were primary decision-makers were more frequent in the S (vs. NS) group (60.9% vs. 30.8%, p = 0.033).

Conclusion

This descriptive analysis revealed lower CS rates among patients aged < 30 years. Sedation was not associated with shortened survival. Dyspnea was the most common sedation indication, with high-dose opioid use, delirium incidence, and spousal decision-making as primary factors associated with sedation administration. Given the small sample size and retrospective design, findings should be interpreted as exploratory.