Is the presence of dyspnea a risk factor for morbidity in cancer patients?

Data collected from six home palliative care teams in Ireland were analyzed to determine the prevalence of dyspnea in the population studied and to id entify factors associated with the presence of dyspnea that might impact on future care. The prevalence of mild, moderate, or severe dyspnea, as measu red by the Support Team Assessment Schedule (STAS), fell from 39% at referr al in 327 evaluable patients to 23%. The presence of dyspnea at referral wa s positively correlated with severity of patient spiritual distress (Spearm an rho = 0.110, P = 0.042) and weakness (Spearmen rho = 0.105, P = 0.008) a t referral. In analysis of contingency tables, dyspnea was also significant ly associated with low patient (chi(2) 4.14, P = 0.04), male sex (chi(2) 8. 9, P = 0.003), a diagnosis of lung cancer (chi(2) 59.88, P < 0.001), and dy ing in hospital rather than hospice or nursing home (chi(2) 18.03, P = 0.00 1). In adjusting for covariates using a logistic regression analysis, howev er, only the presence of low family well-being, a diagnosis of lung cancer, and increased likelihood of a hospital death remained significantly associ ated with the presence of dyspnea at referral. These data suggest that the presence of dyspnea may be associated with increased family distress, which may influence place of death. (C) U.S. Cancer Pain Relief Committee, 2000.