Palliative Care Service, Alfred Hospital, Prahan, Victoria, Australia.
J Palliat Med. 2013 May;16(5):537-41. doi: 10.1089/jpm.2012.0377.
Current evidence indicates that patients with hematological malignancies are less likely to receive input from specialist palliative care services compared to those with solid tumors.
We aimed to analyze data for referrals to our palliative care service, in order to assess trends in the number and proportion of referrals received from hematology, and changes in the characteristics of these referrals.
Prospective information was collected for all referrals to the Department of Pain and Palliative Care (DPPC) over a four-year period. This included inpatient/outpatient status, diagnosis, symptoms, and goals of the referring clinician; and information linked to hospital inpatient data to obtain date and location of death.
SETTINGS/PARTICIPANTS: All hematology referrals were from January 2007 to December 2010.
Hematology referrals constituted 11.6% of all referrals received during the study period. Outpatient referrals increased significantly with each year, as did the proportion of patients referred for symptom control. The median time from referral to death was 34 days, with poorest survival seen in acute leukemia and inpatients. Overall, 54% of inpatient hematology deaths had consultation from the DPPC, with these patients less likely to die in the intensive care unit.
Over recent years, collaboration between hematology and palliative care has resulted in increased referral numbers, with potentially positive results for patients.
目前的证据表明，与实体瘤患者相比，血液系统恶性肿瘤患者接受专业姑息治疗服务的可能性较小。
我们旨在分析向我们姑息治疗服务转诊的数据，以评估来自血液科的转诊数量和比例的趋势，并评估这些转诊的特征变化。
前瞻性地收集了 DPPC（疼痛和姑息治疗科）在四年期间的所有转诊患者的信息。这些信息包括住院/门诊状态、诊断、症状和转诊医生的治疗目标；以及与医院住院患者数据相关的信息，以获取死亡日期和地点。
地点/参与者：所有血液科的转诊都来自 2007 年 1 月至 2010 年 12 月。
血液科转诊占研究期间所有转诊的 11.6%。随着时间的推移，门诊转诊显著增加，转诊用于症状控制的患者比例也有所增加。从转诊到死亡的中位数时间为 34 天，急性白血病和住院患者的生存最差。总体而言，54%的住院血液科死亡患者接受了 DPPC 的咨询，这些患者在重症监护病房死亡的可能性较小。
近年来，血液科和姑息治疗之间的合作导致转诊数量增加，可能对患者产生积极的结果。
