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Association between respiratory and heart rate fluctuations and death occurrence in dying cancer patients: continuous measurement with a non-wearable monitor

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Abstract

Background

The present study aimed to explore the association between impending death and continual changes in respiratory and heart rates measured using a non-wearable monitor every minute for the final 2 weeks of life in dying cancer patients.

Methods

In this longitudinal study, we enrolled patients in a palliative care unit and continuously measured their respiratory and heart rates via a monitor and additionally captured their other vital signs and clinical status from medical records.

Result

A dataset was created comprising every 24-h data collected from every-minute raw data, including information from 240 days prior to death from 24 patients (345,600 data); each patient’s data were measured for 3–14 days until death. After confirming the associations between the respiratory and heat rate values on the day of death (n = 24) or other days (2–14 days before death, n = 216) and the mean, maximum, minimum, and variance of respiratory and heart rates every 24 h by univariate analyses, we conducted a repeated-measures logistic regression analysis using a generalized estimating equation. Finally, the maximum respiratory rate and mean heart rate were significantly associated with death occurring within the following 3 days (0–24 h, 0–48 h, and 0–72 h), except for the maximum respiratory rate that occurs within 0–24 h.

Conclusion

The maximum respiratory rate and mean heart rate measured every minute using a monitor can warn family caregivers and care staff, with the support of palliative care professionals, of imminent death among dying patients at home or other facilities.

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Data availability

All authors shared the raw data. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Masanobu Kawazoe, Mamoru Okumoto, Nobuhiro Nakamura, Tatsuto Suzuki, Ichiro Mori, Yuki Moriki, and Yuko Ohno from the DAIKIN research project team.

Funding

This study was funded by Grant-in-Aid for Scientific Research B by the Ministry of Education, Culture, Sports, Science and Technology (18H03112) and a research grant from Daikin Industry. This article was also supported by the Clinical Investigator’s Research Project at the Osaka University Graduate School of Medicine.

Author information

Authors and Affiliations

  1. Department of Home Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-15 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Sakiko Fukui

  2. Department of Evidence-Based Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan

    Sakiko Fukui, Kasumi Ikuta, Miyae Yamakawa & Momoe Utsumi

  3. Department of Palliative Care, Senri-Chuo Hospital, Toyonaka, Osaka, Japan

    Isseki Maeda

  4. Department of Biomedical Statistics, Graduate School of Medicine, and Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan

    Satoshi Hattori

  5. Department of Palliative Care, Daini Kyoritsu Hospital, 5–28 Sakaemachi, Kawanishi, Hyogo, Japan

    Yutaka Hatano

  6. Department of Nursing, Osaka Medical College, Takatsuki, Osaka, Japan

    Yoko Higami

  7. Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan

    Haruka Tanaka

  8. Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Akari Higuchi

Authors
  1. Sakiko Fukui
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  2. Kasumi Ikuta
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  3. Isseki Maeda
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  4. Satoshi Hattori
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  5. Yutaka Hatano
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  6. Miyae Yamakawa
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  7. Momoe Utsumi
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  8. Yoko Higami
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  9. Haruka Tanaka
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  10. Akari Higuchi
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Contributions

SF managed this study as a principal investigator. MY, MU, HT, YH, and AH designed the study. KI, IM, and YH collected the data and created a dataset. SF and SH analyzed the data. SF, KI, IM, and SH drafted the report. All authors have read and approved the final report.

Corresponding author

Correspondence to Sakiko Fukui.

Ethics declarations

Ethics approval and consent to participate

This study was conducted with the approval of the Ethics Review Committee of Intervention Studies and Observational Research, Osaka University Hospital (approval number: 1741110). After explaining the study protocol to eligible patients, written informed consent was obtained from each patient. Participation in the study was voluntary, and patients were informed that all data would be anonymous and their privacy and personal information would be protected. If a patient did not have sufficient mental capacity to decide on study participation, written consent was obtained from the patient’s family/proxy.

Consent for publication

All authors have approved for publication of this report in BMC Medical Research Methodology.

Competing interests

The authors declare no competing interests.

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Highlights

• Non-wearable monitor measures respiratory and heart rate changes in dying patients

• Maximum respiratory rate was significantly associated with death within the next 3 days

• Mean heart rate was significantly associated with death within the following 3 days

• Monitoring vital data in dying patients enhances quality care

Supplementary Information

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Supplementary file1 (PDF 81 KB)

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Fukui, S., Ikuta, K., Maeda, I. et al. Association between respiratory and heart rate fluctuations and death occurrence in dying cancer patients: continuous measurement with a non-wearable monitor. Support Care Cancer 30, 77–86 (2022). https://doi.org/10.1007/s00520-021-06346-y

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  • DOI: https://doi.org/10.1007/s00520-021-06346-y

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