Palliative Sedation at Home in Patients with Advanced Cancer: A Retrospective Observational Study of Clinical Characteristics and Sedation-Related Outcomes

Background/Objectives: Palliative sedation may relieve refractory suffering in patients with advanced cancer receiving end-of-life care at home. We aimed to describe patient characteristics, palliative sedation use, refractory symptoms, and sedation-related outcomes in a specialized hospital-at-home unit. Methods: We conducted a retrospective observational study of patients with advanced cancer who died during 2022 while receiving care from the Instituto Valenciano de Oncología hospital-at-home unit, Spain. Admission required clinical and social assessment confirming the need for hospital-level home care, feasibility of care at home, and adequate caregiver support. Sociodemographic, clinical, and sedation-related data were obtained from medical records. Analyses were descriptive and exploratory; associations were unadjusted. Results: The cohort included 113 patients; 80 (70.8%) received palliative sedation. Median age was 76 years (IQR, 19), and 59 patients (52.2%) were men. An elastomeric infuser was used in 74 sedated patients (92.5%). Sedation duration had a median of 1 day (IQR, 2; range, 0–10). Symptom documentation was available for 56 sedated patients (70.0%); dyspnea was documented in 35 (62.5%), delirium in 19 (33.9%), and pain in 14 (25.0%). Symptoms could coexist. The median number of parenteral medications was 4 (IQR, 1). Conclusions: Palliative sedation was frequently used in this selected specialized home-care cohort and generally lasted a short period. The prevalence should not be generalized to other settings. Incomplete documentation and the retrospective, single-centre design limit interpretation. Prospective multi-centre studies are needed.