Factors associated with lack of proper hydration in terminal cancer patients.

Abstract

195 Background: Dehydration is a frequent problem in patients suffered from terminal cancer. It decreases the quality of life and increases the amount of complications. The aim of our study was to determine factors connected with dehydration in patients with terminal cancer. Methods: 310 terminal cancer patients admitted to Palliative Care Unit were retrospectively analyzed. Detailed physical examination, medical history including history taken from family and care givers was taken upon admission. Laboratory parameters including morphology, concentration of sodium, potassium, total and ionized calcium, LDH were taken on admission. Univariate and multivariate logistic regression analysis were used to determine possible predictors, symptoms and consequences of dehydration. Results: On admission 34,51% of patients were dehydrated. They had more frequently: metastases (OR = Odds Ratio = 2,77, p = probability value = 0,019), nausea and vomiting (OR = 2,234,p = 0,0176), dyselectrolytemia (OR = 2,609, p = 0,0007); had higher PS scale note (OR = 1,458, p = 0,0031); were more often cachectic (OR = 2,482, p = 0,0003); had lower albumin level (OR = 0,931 ,p = 0,0008). They had 235% higher risk of death (OR = 2,356, p = 0,0007). Multivariate logistic regression analysis after adjustment for possible confounders reviled that occurrence of: metastases (OR = 2,665, p = 0,045), cachexia (OR = 2,105; p = 0,01) and nausea and vomiting (OR = 2,727, p = 0,026) remained independently associated with dyselectrolytemia. Conclusions: Occurrence of metastases, occurrence of nausea and vomiting and occurrence of cachexia are factors associated with dehydration. Patients with lack of proper hydration had 235% higher risk of death. Project "Extension of life and improvement of its quality and reduction of cancer patients' mortality due to proper control of water and electrolytes management and elimination of risk factors for dehydration and dyselectrolytemia" co-financed by the European Social Fund under the project of the Ministry of Science and Higher Education of Poland entitled "Best of the best! 2.0".