Risk factors for death rattle in terminally ill cancer patients: a prospective exploratory study

Death rattle is frequently observed in cancer patients whose death is impen ding and may contribute to the severe distress of patients and their family members. To identify risk factors for development and persistency of death rattle, a prospective study was performed on 245 hospice inpatients. One-hu nd red-and-seven patients (44%) developed death rattle, 71% of whom achieved satisfactory symptom palliation until death. A multiple regression analysis identified neoplasms of brain and lung as independent risk factor s for development of death rattle, while refractory symptoms were significa ntly associated with pulmonary neoplasms and infection/oedema. In conclusion, development of death rattle was influenced by both brain and lung malignancies, while its persistency was mainly determined by pulmonar y pathology. A clinical classification of death rattle based on these facto rs would be established by a further confirmatory study.