Publications by authors named "Ritsuko Yabuki"

4 Publications

  • Page 1 of 1

Does Urinary Catheterization Affect the Quality of Death in Patients with Advanced Cancer? A Secondary Analysis of Multicenter Prospective Cohort Study.

J Palliat Med 2021 Oct 11. Epub 2021 Oct 11.

Department of Palliative Medicine, Kobe University School of Medicine, Kobe, Japan.

Patients with life-limiting illnesses frequently experience urinary difficulties, and urinary catheterization is one of the interventions for managing them. However, evidence supporting the effects of urinary catheters on the quality of death (QoD) is lacking in this population. To investigate whether urinary catheterization affects QoD in patients with advanced cancer in palliative care units. A secondary analysis of a multicenter, prospective cohort study. The study enrolled consecutive patients with advanced cancer admitted to palliative care units in Japan between January and December 2017. Those who were not catheterized on admission and who died while in a palliative care unit were analyzed. QoD was evaluated at death using the Good Death Scale (GDS). Of 885 patients, 297 (33.6%) were catheterized during their palliative care unit stay. Females and patients with a long palliative care unit stay were more likely to be catheterized. In inverse probability-weighted propensity score analysis, patients with urinary catheterization during their palliative care unit stay had higher total GDS scores than those without catheterization (coefficient 0.410, 95% confidence interval 0.068-0.752). In subgroup analyses stratified by sex, age, and length of palliative care unit stay, urinary catheterization was associated with higher total GDS scores in patients younger than 65 years of age and those who died after a palliative care unit stay of 21 days or fewer. This study suggested that urinary catheterization during a palliative care unit stay may have a positive impact on overall QoD in patients with advanced cancer. This study was registered in the UMIN Clinical Trials Registry (UMIN000025457).
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http://dx.doi.org/10.1089/jpm.2021.0178DOI Listing
October 2021

Differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units: A multicenter prospective cohort study (EASED).

Palliat Med 2021 04 21;35(4):799-805. Epub 2021 Jan 21.

Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

Background: Studies on the appropriate use of urinary catheters for cancer patients at the end of life are limited.

Aim: To clarify the differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units.

Design: Pre-planned secondary analysis of a multicenter, prospective cohort study; East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED).

Setting/participants: This study enrolled consecutive advanced cancer patients admitted to palliative care units between January and December 2017. The final study group comprised 1212 patients from 21 institutions throughout Japan.

Results: Out of the 1212 patients, 380 (31.4%; 95% confidence interval, 28.7%-34.0%) underwent urinary catheterization during their palliative care unit stay, and the prevalence of urinary catheterization in patients who died at palliative care units by institution ranged from 0.0% to 55.4%. When the 21 participating institutions were equally divided into three groups according to the institutional prevalence of catheterization, patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation were more likely to be catheterized in institutions with a high prevalence of catheterization than in those with a low or moderate prevalence ( < 0.008,  = 0.008, and  < 0.008, respectively).

Conclusion: This study revealed that the institutional prevalence of urinary catheterization in advanced cancer patients at palliative care units widely varied. Further studies are needed to establish the appropriate use of urinary catheters, especially in patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation.
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http://dx.doi.org/10.1177/0269216321989564DOI Listing
April 2021

Barriers to inpatient palliative care consultation among patients with newly diagnosed cancer after emergency admission.

Ann Palliat Med 2020 Jul 17;9(4):1571-1576. Epub 2020 Jun 17.

Tsukuba Medical Center Hospital, Department of Palliative Medicine, Tsukuba, Japan.

Background: Many patients with advanced cancer diagnosed following emergency presentation will likely benefit from palliative care (PC) interventions. This study assessed the potential patient-related barriers to inpatient PC consultation among patients who were newly diagnosed with cancer after emergency admission (EA) and received only supportive care.

Methods: This observational study retrospectively obtained data on all patients who were admitted to our hospital after emergency transfer between January 2012 and November 2016. We identified patients for whom cancer was listed as the primary disease in the post-hospitalization discharge summary. Out of these patients, we selected those with newly diagnosed cancer and determined whether they were referred for inpatient PC consultation.

Results: This study recruited 141 patients with newly diagnosed cancer after EA (1.2% of all emergency transfer cases). Following diagnosis, the PC team intervened in 29.8% of all the patients enrolled in this study and in 53.3% of patients who received only supportive care. In patients who received only supportive care, the patients who were not referred for PC consultation were significantly more likely to have shorter survival time and less likely to receive disclosure about their cancer diagnosis than patients who were referred.

Conclusions: According to this study, short survival time and no disclosure of cancer diagnosis are potential patient-related barriers to inpatient PC consultation among patients with newly diagnosed cancer after EA.
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http://dx.doi.org/10.21037/apm-19-504DOI Listing
July 2020

[A Retrospective Cohort Study on the Effectiveness of Red Blood Cell Transfusions in Terminally Ill Cancer Patients at a Single Japanese Medical Facility].

Gan To Kagaku Ryoho 2020 Jan;47(1):45-48

Dept. of Palliative Medicine, Tsukuba Medical Center Hospital.

To determine factors related to the effectiveness of red blood cell transfusions in terminally ill cancer patients, we conducted a retrospective cohort study. We studied 27 terminally ill cancer patients who were transfused with red blood cells at our hospitalbetween June 2015 and September 2017. Patients who responded to the treatment("responders"; 16 cases[59%]) were compared with those who did not("non-responders"; 11 cases[40%]). Comparative predictive factor analysis revealed statistically significant differences between responders and non-responders in Eastern Cooperative Oncology Group performance status(PS)(p=0.004)and palliative prognostic index(PPI)scores(p=0.022). Furthermore, a statistically significant difference in median post-transfusion survivaltimes(MST)(p=0.047)was found between responders(69 days; quartile range: 20-141 days)and non-responders(22 days; quartile range: 11-47 days). These results suggested that PPI and PS were significant predictors of the effectiveness of red blood cell transfusions in palliative care, and transfusion effectiveness was related to post-transfusion survivaltime.
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January 2020
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