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Dying of hematologic patients—treatment characteristics in a German University Hospital

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Abstract

The treatment of hematologic patients in palliative situations remains a major challenge as there are special clinical needs, e.g., transfusions and the high risk for infectious complications with subsequent use of broad anti-infective treatment. Furthermore, most hematologic patients have a relatively long history of disease and are acquainted with “their” wards; that is why most are treated on these hematologic and not on specialized palliative wards. The standardized approach to the care of hematologic patients with curative treatment intention is probably not fully appropriate for palliative patients. In order to evaluate the current situation of treatment characteristics in a German university hospital, we retrospectively evaluated the medical documentation of all patients who died on a hematologic ward between 2005 and 2008. While we found a high number of chemotherapeutic, anti-infective, analgesic, and sedative treatments, of transfusions, of treatment on the intensive care units, and of invasive nature, non-somatic interventions were rather scarce. Symptom control, e.g., for bleeding events or pain, was frequently not adequately achieved. With regard to the palliative situation, a holistic approach with the maintenance of patients’ autonomy and the preference for dying at home, the treatment of hematologic patients in a palliative situation has to be reconsidered.

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Acknowledgments

We deeply acknowledge our patients and their relatives for their continued trust in us.

Conflict of interest

All authors state that there are no conflicts of interest.

Primary data

Primary data is under full control of the authors, as all data were extracted from the clinical documentation of each patient.

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Authors and Affiliations

  1. Department of Medicine, Haematology and Oncology, University Hospital of Giessen, Giessen, Germany

    Patrick Brück & Mathias Rummel

  2. Department of Medicine, Hematology and Oncology, University Hospital of Frankfurt a. M., Frankfurt am Main, Germany

    Patrick Brück, Malgorzata Pierzchlewska, Marta Kaluzna-Oleksy, Dieter Hoelzer & Angelika Böhme

  3. Department of Medicine, Endocrinology and Diabetes, University Hospital of Frankfurt a. M., Frankfurt am Main, Germany

    Maria Elizabeth Ramos Lopez

  4. Onkologikum, Frankfurt am Museumsufer, Frankfurt am Main, Germany

    Dieter Hoelzer & Angelika Böhme

  5. Department of Hematology and Oncology, Centre of Internal Medicine, University Hospital Giessen, Klinikstrasse 36, 35392, Giessen, Germany

    Patrick Brück

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  1. Patrick Brück
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  2. Malgorzata Pierzchlewska
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  3. Marta Kaluzna-Oleksy
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  5. Mathias Rummel
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Correspondence to Patrick Brück.

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Brück, P., Pierzchlewska, M., Kaluzna-Oleksy, M. et al. Dying of hematologic patients—treatment characteristics in a German University Hospital. Support Care Cancer 20, 2895–2902 (2012). https://doi.org/10.1007/s00520-012-1417-8

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  • DOI: https://doi.org/10.1007/s00520-012-1417-8

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