UI - 000194

AU - Brescia FJ

AU - Portenoy RK

AU - Ryan M

AU - Krasnoff L

AU - Gray G

TI - Pain, opioid use, and survival in hospitalized patients with advanced cancer

AB - AB - PURPOSE: Pain is a common and feared symptom for patients with incurable cancer.

Comprehensive assessment provides the foundation for effective pain management, and data that clarify the

relationship between pain and other relevant factors also facilitate this process. The main objective of the

study was to develop a clinical data base for advanced cancer patients and to survey data to determine (1)

pain severity at admission, (2) opioid use at admission, (3) change in opioid use during the hospital stay, and

(4) survival in the hospital. PATIENTS AND METHODS: Information was collected prospectively on

1,103 patients admitted and on 1,017 patients who died within 6 months of the study's end. Demographic

and clinical data were recorded 72 hours after admission and soon after death or discharge. RESULTS:

Seventy-three percent of patients had pain at admission. Cancer of the cervix was frequently (68%)

associated with severe pain, as were prostate (52%) and rectal/sigmoid tumors (49%). Severe pain was more

probable in those with bone metastasis, those admitted from home, and in those younger than 55 years of

age. The majority (71.7%) of patients had a stable dosing pattern, and only 4.2% of the patients required

dose increases of at least 10% per day. CONCLUSION: This study demonstrated the wide variability in

opioid doses required. No reliable predictor of opioid requirement was identified, and this lack of

predictability of cancer pain severity underscores the need for ongoing assessment. AD - Calvary Hospital

AD - Bronx AD - NY 10461 UI - 92092056

SO - J Clin Oncol 1992;10:149-15