A systematically structured review of biomarkers of dying in cancer patients in the last months of life; An exploration of the biology of dying

• DOI: 10.1371/journal.pone.0175123
• Publication Date: 2017-04-06T19:45:33Z
• Authors: Victoria Louise Reid; Rachael McDonald; Amara Callistus N...; Stephen R. Mason; Chris Probert; John E. Ellershaw; Séamus Coyle
• Keywords: Science; Q; R; 610; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Neoplasms; Medicine; Humans; Biomarkers; Research Article

Background The Neuberger review made a number of recommendations to improve end life care, including research into the biology dying. An important aspect dying is identification biomarkers as indices disease processes. Biomarkers have potential inform current, limited understanding process and assist clinicians in recognising dying, particular how distinguish from reversible acute deterioration. Objectives To critically appraise literature on biological factors that may be used prognostic indicators advanced cancer patients identify candidate can measured serially patients' bodily fluids. Methods A systematically structured was conducted using three electronic databases. hand search six peer-reviewed journals conference abstracts also conducted. Studies reporting with median survival ≤90 days post-mortem studies were included. Final levels evidence Evidence Based Medicine modified GRADE system. Results 30 articles Seven demonstrated Grade (lymphocyte count, white blood cell serum C-reactive protein, albumin, sodium, urea alkaline phosphatase). additional eleven identified B (platelet international normalised ratio, vitamin B12, prealbumin, bilirubin, cholesterol, aspartate aminotransferase, alanine transaminase, lactate dehydrogenase, pseudocholinesterase urate). specifically last two weeks but limitations exist. No met inclusion criteria. Conclusion an area for future research, focused signs, symptoms factors. This identifies common themes shared amongst highlights which indicative