A new study indicates that clinicians may be able to tell when a patient is likely to die within the next 24 hours using a straightforward bedside check.
One certainty of life is that death will come eventually—ideally many decades from now, after we’ve had time to grow old and learn a few things.
Research suggests about 10 percent of Americans experience what’s called “death anxiety,” while roughly 3 percent report an intense, severe fear of dying.
For those who think often about mortality, it’s natural to wonder what signs doctors look for when assessing whether someone is nearing the end of life.
New findings published in the BMJ Supportive and Palliative Care journal propose that death may be as little as 24 hours away if a patient fails one specific reflex test.
The research was led by Dr Jung Hun Kang, director of the hospice centre at Gyeongsang National University Hospital, and is titled ‘Corneal reflex: novel strong prognostic marker for imminent death’.
To reach their conclusions, the team tracked 112 hospice residents living with advanced cancer.
Doctors had reportedly already informed these patients they likely had about two weeks remaining. Nurses then monitored daily for well-known end-of-life indicators such as altered breathing, blue-tinged skin linked to poor circulation, and decreasing levels of consciousness, according to the Daily Mail.
Alongside those observations, staff were instructed to assess corneal reflex in all 112 participants. Of that group, 110 died within seven days of the study beginning.
The corneal reflex—an involuntary, rapid blink response—was checked three times each day.
To perform the assessment, nurses gently touched the cornea using a sterile cotton wisp or a strand of gauze.
Results were categorized as intact, diminished, or absent. Patients recorded as having an absent reflex were five times more likely to die within 24 hours than those whose reflex was listed as intact or diminished.
Among patients without the reflex, the 24-hour mortality rate was 70.7 percent.
Speaking about the results of the simple test, Dr Kang said: “Absence of the reflex may strongly support a prediction of imminent death, but preservation of the reflex does not rule it out.
“Loss of the corneal reflex may reflect progressive deterioration of brainstem function as part of the natural dying process.”
Dr Kang added that a multi-center follow-up study, involving a broader and more varied patient population, is planned after the initial test was reported to be 95 percent accurate.
MedScape also reported that he aims to explore whether artificial intelligence (AI) could be used to spot subtle clinical patterns—such as changes in corneal reflex—that might be missed by bedside staff.
“Improving care in the final hours of life is just as important as prolonging survival,” he added.
“The better we become at recognizing imminent death, the better we can support a more peaceful and dignified experience for patients and families.”