Quality of end-of-life care in patients with hematological malignancies: potential role of palliative care.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.