A new powerful prognostic marker of imminent death has been identified by researchers at Kyungsan National University in South Korea. The predictor is not a blood test, but the disappearance of the corneal reflex.
Researchers have found that a simple test checking the blink reflex can accurately predict whether a terminally ill patient will pass away within the next 24 hours. This discovery could provide doctors with a new tool for prognosis and give patients and their families invaluable time for farewell, according to a study published in the journal BMJ Supportive and Palliative Care by scientists from Kyungsan University in South Korea.
Scientific Test
The study showed that the absence of the corneal reflex in patients with terminal cancer is a precise and specific sign that a person may die within the next 24 hours.
These conclusions were drawn from experiments with hospice patients. A total of 665 observations were analyzed. Nurses gently touched the surface of the patient's eye with a sterile swab. The reaction could be normal (the person blinked reflexively), weakened, or completely absent.
The findings were as follows: patients who had no corneal reflex had a 5.48 times higher chance of dying within 24 hours compared to those who had it preserved or weakened. In fact, 70.7% of patients with an absent reflex passed away within one day.
The lead author of the study, Dr. Chung Hoon Kang, notes that this test could be a true salvation for families during the most difficult moments.
"In Korea, relatives place great importance on being present at the moment of a loved one's death and often ask doctors the difficult question of how much time is left," says Dr. Kang.
"The corneal reflex may disappear due to dysfunction of the part of the brain that controls vital body functions, including breathing. Its use as a marker of imminent death in palliative care is a new and promising direction," the researchers state.
The corneal reflex test is particularly effective when combined with other indicators, such as the Richmond Agitation-Sedation Scale (RASS). In patients with an absent corneal reflex and a RASS score of "minus 4" or "minus 5," the mortality rate within 24 hours was 71.2% compared to 37.1% for those with a preserved reflex.
Other significant markers of imminent death include:
- peripheral cyanosis (bluish discoloration of fingers, toes, the tip of the nose, ears, lips);
- decreased blood oxygen levels,
- low blood pressure.
Experts urge caution when evaluating this new mortality marker. The study was conducted on a small group of patients, and larger datasets are needed for more accurate results.
The discovery by Korean scientists could become an important tool in palliative medicine, helping to better understand how much time a patient has left. In our opinion, this gives doctors the opportunity to better plan care, while loved ones can be present during the most important moments. At the same time, specialists emphasize that the method requires further research and should be used in conjunction with other indicators.
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