Destined to die in hospital? Systematic review and meta-analysis of place of death in haematological malignancy

BMC Palliative Care

Research Article

Russell Patmore¹  Martin R Howard²  Alexandra G Smith³  Debra A Howell³  Eve Roman³  Helen Cox³  Anne C Garry⁴ 

[1] Department of Haematology, Queens Centre for Oncology and Haematology, Castle Hill Hospital, Castle Road, HU16 5JQ, Cottingham, East Yorkshire, UK;Department of Haematology, York Hospital, Wigginton Road, YO31 8HE, York, UK;Epidemiology and Genetics Unit, Department of Health Sciences, University of York, Seebohm Rowntree Building, YO10 5DD, UK;Palliative Medicine, North Yorkshire and York PCT, YO31 8HE, York, UK;

关键词: Palliative Care;    Haematological Malignancy;    Prefer Place;    Hospital Death;    Advance Care Planning;   

DOI  :  10.1186/1472-684X-9-9

 received in 2010-01-18, accepted in 2010-06-01,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundHaematological malignancies are a common, heterogeneous and complex group of diseases that are often associated with poor outcomes despite intensive treatment. Research surrounding end-of-life issues, and particularly place of death, is therefore of paramount importance, yet place of death has not been formally reviewed in these patients.MethodsA systematic literature review and meta-analysis was undertaken using PubMed to identify all studies published between 1966 and 2010. Studies examining place of death in adult haematology patients, using routinely compiled morbidity and mortality data and providing results specific to this disease were included. 21 studies were identified with descriptive and/or risk-estimate data; 17 were included in a meta-analysis.ResultsCompared to other cancer deaths, haematology patients were more than twice as likely to die in hospital (Odds Ratio 2.25 [95% Confidence Intervals, 2.07-2.44]).ConclusionHome is generally considered the preferred place of death but haematology patients usually die in hospital. This has implications for patients who may not be dying where they wish, and also health commissioners who may be funding costly end-of-life care in inappropriate acute hospital settings. More research is needed about preferred place of care for haematology patients, reasons for hospital deaths, and how these can be avoided if home death is preferred.

【 授权许可】

CC BY   
© Howell et al; licensee BioMed Central Ltd. 2010