Table 3.

Symptom Prevalence in the Final Days of Life

Study	Lichter et al. 1990[8]	Conill et al. 1997[9]	Freeborne et al. 2000[10]	Hall et al. 2002[12]	Toscani et al. 2005[13]	Hwang et al. 2012[15]	Hui et al. 2015[16]
Design	Prospective/retrospective	Prospective	Retrospective	Retrospective	Retrospective	Retrospective	Prospective
Population	200 deaths	176 consecutive patients with advanced cancer	2598 enrolled patients (41% cancer)	185 convenience sample (14% cancer)	370 patients (25% cancer)	181 patients with advanced cancer	357 consecutive patients with advanced cancer
Setting (place of death)	Hospice (home or inpatient)	Home, hospitals, hospices	Home, hospitals	Long term care	Hospitals	Palliative care unit	Palliative care units
Symptom assessment	Research nurses’ impression when patients were likely to die or after death	Clinicians’ impression in the last week of life	Caregiver recall after death	Chart documentation	Nurse recall after death	Chart documentation	Edmonton symptom assessment scale among patients who were able to communicate, nursing impression
Time frame	Last 2 d	Last 7 d	Last 3 d	Last 2 d	Last 3 d	Last 2 d	Last 3 d serially
Fatigue	NR	82%	80%	NR	93%	NR	60–78%†
Pain	51%	30%	34–45%*	44%	75%	24%	38–50%†
Anorexia	NR	80%	NR	NR	73%	5%	74–83%†
Dyspnea	22%	47%	28–83%*	62%	70%	21%	48–73%†
Confusion	9%	68%	24–34%*	29%	55%	33%	NR
Dysphagia	29%	46%	NR	28%	49%	NR	24–53%‡
Death rattle	56%	NR	NR	39%	45%	NR	11–39%‡
Myoclonus	12%	NR	NR	16%	NR	NR	8–11%‡
Incontinence	32%	NR	NR	NR	57%	NR	39–65%‡
Anxiety	NR	46%	25%	NR	NR	6%	49–57%†

Abbreviations: NR, not reported

^*Patients with advanced lung and colon cancer

^†Frequency of symptoms with intensity of >=4/10 as reported by patients in the last 3 days of life

^‡Frequency of symptoms with as observed by nurses in the last 3 days of life