Hospital Palliative Care Team Involvement in Inpatients with Hematologic Malignancies: A Retrospective Study.

Abstract

<b><i>Background:</i></b> Data on the involvement of hospital palliative care teams (HPCT) in the management of patients with hematologic malignancies (HM) are limited. <b><i>Objectives:</i></b> To describe characteristics, symptom burden according to the German Hospice and Palliative Care Evaluation assessment tool, and course of inpatients with HM who were referred to a HPCT, and compare them with their counterparts with solid tumors (ST). <b><i>Design:</i></b> Retrospective analysis. <b><i>Setting/Subjects:</i></b> Inpatients with HM and ST who were referred to the HPCT of a comprehensive cancer center in Germany between January 1, 2015, and December 31, 2019. <b><i>Results:</i></b> The analysis included 2885 patients; 412 (14.3%) had HM and 2473 (85.7%) had ST. Patients with HM more often experienced depression (<i>p</i> = 0.003), tension (<i>p</i> < 0.001), and disorientation (<i>p</i> = 0.003); pain (<i>p</i> = 0.029), nausea (<i>p</i> = 0.003), weakness (<i>p</i> < 0.001), loss of appetite (<i>p</i> = 0.005), tiredness (<i>p</i> < 0.001), and need for assistance with activities of daily living (<i>p</i> < 0.001) were more common in patients with ST. Patients with HM were more often admitted to the intensive care unit (ICU) (<i>p</i> < 0.001), had longer ICU stays (<i>p</i> = 0.005), and had a higher death rate (<i>p</i> < 0.001) during their last stay in the hospital. The time between the first contact with the HPCT and death was shorter for patients with HM (<i>p</i> < 0.001). Patients with HM also had a shorter overall time of care by the HPCT (<i>p</i> < 0.001). <b><i>Conclusions:</i></b> As compared with their counterparts with ST, inpatients with HM were closer to death at referral to the HPCT, experienced a comparable overall symptom burden, and were admitted to the ICU more frequently after HPCT involvement.