• Naosuke Yokomichi, Tatsuya Morita, and Takashi Yamaguchi.
• Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
• J Palliat Med. 2022 Jan 1; 25 (1): 130-134.

AbstractBackground: Death rattle occurs frequently in dying patients with malignancies. The association the between hydration volume and death rattle development is controversial. Design and Setting: A secondary analysis using data from two multicenter prospective observational studies, including a total of 471 consecutive advanced cancer patients. Of these, we analyzed patients with abdominal malignancies. Measurements: The association of an artificial hydration volume one week before death with the development of death rattle 48 hours before death was evaluated with the adjustment of potential confounders using the propensity score-weighting method. Results: We analyzed 300 patients. The prevalence of death rattle was significantly higher in those receiving artificial hydration >500 mL/day than those receiving ≤500 mL/day (23.1% vs. 13.6%, respectively; adjusted odds ratio: 2.56; 95% confidence interval: 1.37-4.80; p = 0.0036). Conclusion: The hydration volume might be associated with death rattle development in patients with abdominal malignancies. Volume reduction may alleviate or prevent death rattle.

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