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

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.