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Eight Clinical Signs of Impending Death Identified

Findings in patients with advanced cancer could help families prepare, aid end-of-life care choices

MONDAY, Feb. 9, 2015 (HealthDay News) — Researchers say they have identified eight specific physical signs that strongly indicate impending death in patients with advanced cancer. The findings have been reported online Feb. 9 in Cancer.

David Hui, M.D., professor in the department of palliative care and rehabilitation medicine at the University of Texas MD Anderson Cancer Center in Houston, and colleagues focused on telltale signs that a patient has, at most, just three days to live. The hope is that this information will help family members and other caregivers better handle an impending death, as well as be more prepared for choices that may have to be made during end-of-life care. To compile their list, the researchers monitored physical changes that occurred just prior to death among 357 advanced-stage cancer patients. They were being treated at one of two cancer centers: one in the United States and one in Brazil. All of the patients were in an acute palliative care unit. Physical changes were noted twice daily.

During the study time frame, more than half (57 percent) of the patients died. And in the end, the authors settled on eight indicators that seemed to most accurately predict imminent death. Those included: an inability to close the eyelids; diminishing ability to react to visual stimulation; a reduced ability to react to sounds and words; facial drooping; non-reactive pupils; hyperextension of the neck; vocal cord grunting; and bleeding in the upper digestive tract.

“It is important to point out that only a small proportion of patients may have each of the signs before death, although a majority would have at least one of the signs in the last three days of life,” Hui told HealthDay. “The presence of these signs strongly suggests that death will occur in the next three days. However, absence of these signs does not suggest that death will not occur.”

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