Palliative care is related to less aggressive end-of-life treatment in haematology-oncology: a retrospective cohort study.

IF 2 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Supportive & Palliative Care Pub Date : 2025-03-18 DOI:10.1136/spcare-2024-005089

Davide Facchinelli, Corinna Greco, Manuela Rigno, Daniela Menon, Pietro Manno, Leonardo Potenza, Claudio Cartoni, Marcello Riva, Laura Dalla Verde, Anna Varalta, Alberto Tosetto

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引用次数: 0

Abstract

Objectives: Patients with haematological malignancies (HM) experience high-intensity medical care near the end of life (EOL), have low rates of hospice and palliative care (PC) use and are more likely to die in the hospital. We compared the quality indicators for EOL care in patients followed by a haematologist with or without PC.

Methods: This observational, retrospective study evaluated a cohort of 196 consecutive patients with HM. We used a mean composite score for the aggressiveness of EOL. The quality indicators evaluated were chemotherapy, place of death, transfusions and hospital use in the last month of life.

Results: Eighty patients were offered PC and 116 were not. The composite score for aggressive EOL care was significantly higher for patients not followed by PC (2.2 vs 0.5; p<0.0001). None of the PC group patients was intubated or admitted to intensive care; 91.2% of the patients followed by PC died at home or in hospice, while 81.9% of the other patients died in the hospital.

Conclusion: Many patients who died of HM received intensive treatment near EOL. Our data support the value of integrating PC into the HM routine practice and can be the basis for new studies.

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姑息治疗与血液肿瘤学中不那么积极的临终治疗有关：一项回顾性队列研究。

目的：血液病恶性肿瘤（HM）患者在生命末期（EOL）经历高强度的医疗护理，使用临终关怀和姑息治疗（PC）的比例较低，并且更有可能在医院死亡。我们比较了血液学家随访的有或没有PC的患者EOL护理的质量指标。方法：这项观察性、回顾性研究评估了196例连续HM患者的队列。我们使用平均综合评分来衡量EOL的侵袭性。评估的质量指标包括化疗、死亡地点、输血和生命最后一个月的住院情况。结果：80例患者行PC治疗，116例未行PC治疗。未接受PC治疗的患者，积极EOL护理的综合评分明显更高(2.2 vs 0.5；结论：许多HM死亡患者在生命末期接受了强化治疗。我们的数据支持将PC纳入HM常规实践的价值，并可作为新研究的基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Supportive & Palliative Care Medicine-Medicine (miscellaneous)

CiteScore

4.60

自引率

7.40%

发文量

170

期刊介绍： Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance. We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication. In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.