Work

Exploring laboratory and clinical factors associated with sudden unexpected death in patients receiving palliative care

Year: 2026

Type: article

Abstract: Purpose Sudden unexpected death (SUD) in palliative care disrupts care planning and increases familial grief. This study aimed to identify objective laboratory risk factors for SUD to improve prognostic accuracy. Methods We retrospectively analyzed 530 palliative care patients (March 2019–December 2022). SUD was defined as death within 24 hours of a stable clinical assessment. Multivariable logistic regression and ROC curve analysis were used to evaluate clinical and laboratory predictors, including the modified Glasgow Prognostic Score (mGPS). Results Of the 530 patients, 112 (21.1%) were classified into the SUD group. Multivariable analysis revealed that a history of chemotherapy (OR: 0.562, P = 0.024), serum sodium (OR: 0.933, P = 0.004), chloride (OR: 1.058, P = 0.018), magnesium (OR: 2.120, P = 0.001), and mGPS (OR: 0.612, P = 0.032) were independently associated with SUD. In ROC analysis, serum magnesium (AUC: 0.592) and chemotherapy history (AUC: 0.565) were individual predictors. However, a composite model integrating these variables demonstrated significantly improved discriminative performance (AUC: 0.662; 95% CI: 0.606–0.718; P < 0.001). Conclusions Objective laboratory parameters, particularly serum magnesium and electrolyte imbalances, are significant indicators of SUD risk in palliative care. Integrating these biochemical markers (including chemotherapy history, sodium, chloride, magnesium and mGPS) into clinical assessments through a composite model can enhance the identification of patients at risk for sudden death. This objective approach may support more timely communication with families, proactive care planning, and better emotional preparedness for end-of-life transitions.

Source: BMC Palliative Care

DOI: 10.1186/s12904-026-02325-4

Authors: Su Nam Lee, Ju-Hye Chung, Se-Hong Kim, Youngmi Eun

Institutions: The Catholic University of Korea St. Vincent's Hospital, Catholic University of Korea, The Catholic University of Korea Yeouido St. Mary's Hospital

Language: English

Topic: Palliative Care and End-of-Life Issues

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,990