title: Dying of hematologic patients--treatment characteristics in a German University Hospital.
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.
authors.affiliation: Department of Medicine, Haematology and Oncology, University Hospital of Giessen, Giessen, Germany. patrick.brueck@innere.med.uni-giessen.de
authors.forename: Patrick
authors.initials: P
authors.lastname: Brück
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Pierzchlewska
authors.forename: Marta
authors.initials: M
authors.lastname: Kaluzna-Oleksy
authors.forename: Maria Elizabeth
authors.initials: ME
authors.lastname: Ramos Lopez
authors.forename: Mathias
authors.initials: M
authors.lastname: Rummel
authors.forename: Dieter
authors.initials: D
authors.lastname: Hoelzer
authors.forename: Angelika
authors.initials: A
authors.lastname: Böhme
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D019337:Hematologic Neoplasms / Q000473:pathology / Q000628:therapy*; D006694:Holistic Health; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000209:etiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D000970:Antineoplastic Agents