dc.contributor.author | Button, Elise | |
dc.contributor.author | Gavin, Nicole C | |
dc.contributor.author | Chan, Raymond J | |
dc.contributor.author | Chambers, Shirley | |
dc.contributor.author | Butler, Jason | |
dc.contributor.author | Yates, Patsy | |
dc.date.accessioned | 2019-06-08T01:32:38Z | |
dc.date.available | 2019-06-08T01:32:38Z | |
dc.date.issued | 2018 | |
dc.identifier.issn | 1096-6218 | |
dc.identifier.doi | 10.1089/jpm.2018.0033 | |
dc.identifier.uri | http://hdl.handle.net/10072/385199 | |
dc.description.abstract | Background: Identifying people who are at risk of deteriorating and dying is essential to inform goals of care, appropriate treatment decisions, patient autonomy, and effective end-of-life care. Limited literature exists on predicting survival near the end of life for people with a hematological malignancy. Objective: To identify the key clinical indicators that signal a person with a hematological malignancy is at high risk of deteriorating and dying. Design, Setting, Participants: Eleven clinical indicators identified in a Delphi approach were tested via a retrospective case-control study. Each indicator was assessed for at each in-patient admission between living (n = 236) and deceased (n = 120) people with a hematological malignancy who were admitted to a large tertiary hospital between 1st July 2014 and 31st December 2015. Results: Six clinical indicators were independently associated with mortality in the final three months of life: declining performance status (Odds Ratio [OR] 7.153, 95% Confidence Intervals [CI] 3.281-15.597, p = < 0.001); treatment limitations of the hematological malignancy (OR 7.855, 95% CI 3.528-17.489, p = < 0.001); relapse, refractory or persistent disease (OR 3.749, 95% CI 1.749-8.039, p = 0.001); presence of two or more comorbidities (OR 2.991, 95% CI 1.319-6.781, p = 0.009); invasive fungal infections (OR 4.887, 95% CI 1.197-19.949, p = 0.027); and persistent infections (OR 6.072, 95% CI 2.551-14.457, p = < 0.001). Conclusions: This study has identified six clinical indicators that signal a person with a hematological malignancy is at high risk of deteriorating and dying and may benefit from an assessment of palliative needs and proactive planning, along-side appropriate treatment. | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.relation.ispartofpagefrom | 1729 | |
dc.relation.ispartofpageto | 1740 | |
dc.relation.ispartofissue | 12 | |
dc.relation.ispartofjournal | Journal of Palliative Medicine | |
dc.relation.ispartofvolume | 21 | |
dc.subject.fieldofresearch | Clinical sciences | |
dc.subject.fieldofresearch | Nursing | |
dc.subject.fieldofresearch | Health services and systems | |
dc.subject.fieldofresearch | Public health | |
dc.subject.fieldofresearchcode | 3202 | |
dc.subject.fieldofresearchcode | 4205 | |
dc.subject.fieldofresearchcode | 4203 | |
dc.subject.fieldofresearchcode | 4206 | |
dc.title | Clinical Indicators That Identify Risk of Deteriorating and Dying in People with a Hematological Malignancy: A Case-Control Study with Multivariable Analysis | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Chan, Ray | |