Table 1.
| Physical Signs | Frequency of sign in last 3 days of life, % |
Median Onset in days (Q1-Q3) |
Specificity (95% CI) |
Positive Likelihood Ratio (95% CI) |
|---|---|---|---|---|
| Cheyne Stokes breathing | 41 | 2.0 (1.0–2.0) | 98.5 (98.4–98.7) | 12.4 (10.8–13.9) |
| Death rattle | 66 | 1.5 (1.0–2.0) | 97.1 (96.9–97.3) | 9 (8.1–9.8) |
| Decreased response to verbal stimuli | 69 | 2.0 (1.5–4.0) | 96 (95.8–96.3) | 8.3 (7.7–9) |
| Decreased response to visual stimuli | 70 | 3.0 (2.0–4.0) | 94.9 (94.6–95.1) | 6.7 (6.3–7.1) |
| Drooping of nasolabial fold | 78 | 2.5 (1.5–3.0) | 95.5 (95.3–95.8) | 8.3 (7.7–8.9) |
| Grunting of vocal cords | 54 | 1.5 (1.0–2.0) | 97.9 (97.7–98.1) | 11.8 (10.3–13.4) |
| Hyperextension of neck | 46 | 2.5 (2.0–3.0) | 96.7 (96.5–96.9) | 7.3 (6.7–8) |
| Inability to close eyelids | 57 | 1.5 (1.0–1.5) | 97.9 (97.7–98.1) | 13.6 (11.7–15.5) |
| Non-reactive pupils | 38 | 2.0 (1.5–3.0) | 99 (98.8–99.1) | 16.7 (14.9–18.6) |
| Palliative performance scale ≤20% | 93 | 4.0 (3.5–6.0) | 81.3 (80.9–81.7) | 3.5 (3.4–3.6) |
| Peripheral cyanosis | 59 | 3.0 (2.0–4.5) | 94.9 (94.7–95.2) | 5.7 (5.4–6.1) |
| Pulselessness of radial artery | 38 | 1.0 (0.5–1.0) | 99.3 (99.2–99.5) | 15.6 (13.7–17.4) |
| Respiration with mandibular movement | 56 | 1.5 (1.0–2.0) | 97.5 (97.3–97.6) | 10 (9.1–10.9) |
| Richmond Agitation Sedation Scale ≤-2 | 90 | 4.5 (3–6) | 89.3 (88.9–89.7) | 4.9 (4.7–5) |
| Upper gastrointestinal bleed | 5 | 5.5 (0.5–17.0) | 99.7 (99.6–99.7) | 10.3 (9.5–11.1) |
| Urine output over last 12 h <100 ml | 72 | 1.5 (1.0–2.5) | 98.2 (98–98.5) | 15.2 (13.4–17.1) |
Abbreviations: CI, confidence interval; Q1-Q3, interquartile range