Symptom control for the patients (n=65) managed on the PDOC guideline palliative care protocol
| Protocol features | Good symptom control | Difficult symptom control | All | |
|---|---|---|---|---|
| N=50 | N=15 | N=65 | ||
| Protocol stage* N (%) | 1 | 47 (94%) | 7 (47%) | 54 (83%) |
| 2 | 2 (4%) | 6 (40%) | 8 (12%) | |
| 3 | 1 (2%) | 2 (13%) | 3 (5%) | |
| PDOC diagnosis at death | Coma | 2 (4%) | - | 2 (3%) |
| VS | 23 (46%) | 8 (53%) | 31 (48%) | |
| MCS | 20 (40%) | 7 (47%) | 27 (42%) | |
| Emerged | 5 (10%) | - | 5 (8%) | |
| CANH withdrawn N (%) | Yes | 29 (58%) | 8 (53%) | 37 (57%) |
| No | 21 (42%) | 7 (46%) | 28 (43%) | |
| Max dose morphine mg/24 hrs | Mean (95%CI) | 33 (27, 41) | 90 (61, 120) | 46 (36, 58) |
| Range | 0–100 | 10–240 | 0–240 | |
| Max dose midazolam mg/24 hrs | Mean (95%CI) | 35 (28, 42) | 76 (58, 91) | 44 (36, 52) |
| Range | 0–100 | 10–100 | 0–100 | |
| Other medications N (%) | Levomepromazine | 1 (2%) | 5 (33%) | 6 (9%) |
| Phenobarbitone | 2 (4%) | 3 (20%) | 5 (8%) | |
| Anti-emetics | 9 (16%) | 6 (40%) | 15 (23%) | |
| Drying agents | 2 (4%) | 4 (27%) | 6 (9%) | |
| Other | 2 (4%) | 2 (3%) | ||
| Mode of death | Bronchopneumonia | 26 (52%) | 8 (53%) | 34 (52%) |
| Multi-organ failure | 18 (36%) | 5 (33%) | 23 (35%) | |
| Respiratory failure | 2 (4%) | 2 (13%) | 4 (6%) | |
| Cardiac event/failure | 2 (4%) | 2 (3%) | ||
| Other | 2 (4%) | 2 (3%) | ||
For full description of palliative care protocol stages see Tables 5.2b and 5.2c of the national PDOC guidelines.6 CANH = clinically assisted nutrition and hydration; PDOC = prolonged disorder of consciousness.