Palliative Care Service, Instituto Nacional de Cancerología, Avenida San Fernando 22, Belisario Domínguez, Sección 16, Tlalpan, 14080, Mexico City, Mexico.
Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Support Care Cancer. 2024 Nov 28;32(12):831. doi: 10.1007/s00520-024-09047-4.
Limited data are available on the impact of specialist palliative care on end-of-life care quality for patients with hematologic malignancies. This study aims to analyze the quality of end-of-life care in patients with hematological malignancies, comparing those who receive palliative care with those who do not.
Observational, single center retrospective study. This study was conducted at the National Cancer Institute (INCan) in Mexico City, a tertiary care hospital, between January 2016 and June 2021. This study included deceased patients with hematological malignancies who were hospitalized or patients who were hospitalized and receiving home palliative care, with follow-up from the palliative care service. End-of-life care quality was assessed using the ASCO/NQF instrument.
Three hundred sixty deceased patients with hematological malignancies were included in the analysis; 51.4% were men, with a median age of 52 years. The most common diagnosis was non-Hodgkin lymphoma (41.4%); 37.8% of patients were referred to palliative care, with an average referral time from admission to INCan of 99.5 days. Patients without palliative care referral showed worse quality of death indicators (71.6% vs. 28.4%). Survival analysis revealed a median survival of 5.29 months for patients with up to 3 worse quality of death indicators and 3.65 months for those with ≥ 4 worse quality of death indicators at the end-of-life (p < 0.001).
Patients with hematologic malignancies who did not receive palliative care experienced more intensive end-of-life interventions and had lower overall survival rates. Early integration of palliative care is crucial to promote compassionate approaches near death and ensure quality end-of-life care.
关于血液恶性肿瘤患者接受专科姑息治疗对临终关怀质量的影响，目前仅有有限的数据。本研究旨在分析血液恶性肿瘤患者临终关怀质量，并比较接受姑息治疗与未接受姑息治疗患者的差异。
这是一项在墨西哥城国家癌症研究所（INCan）进行的观察性、单中心回顾性研究。该研究于 2016 年 1 月至 2021 年 6 月期间开展，纳入了因血液恶性肿瘤死亡的住院或接受居家姑息治疗的患者，这些患者均随访自姑息治疗服务。使用 ASCO/NQF 工具评估临终关怀质量。
本研究共纳入 360 例因血液恶性肿瘤死亡的患者；其中 51.4%为男性，中位年龄为 52 岁。最常见的诊断为非霍奇金淋巴瘤（41.4%）；37.8%的患者被转介至姑息治疗，从入院到 INCan 的平均转介时间为 99.5 天。未接受姑息治疗转介的患者死亡指标的质量更差（71.6% vs. 28.4%）。生存分析显示，死亡指标质量较差（≥4 个）的患者中位生存期为 5.29 个月，而死亡指标质量较差（≤3 个）的患者中位生存期为 3.65 个月（p<0.001）。
未接受姑息治疗的血液恶性肿瘤患者接受了更多的临终干预，总生存率更低。早期整合姑息治疗对于在接近死亡时促进富有同情心的治疗方法和确保高质量的临终关怀至关重要。
