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dc.contributor.authorButton, Elise
dc.contributor.authorGavin, Nicole C
dc.contributor.authorChan, Raymond J
dc.contributor.authorChambers, Shirley
dc.contributor.authorButler, Jason
dc.contributor.authorYates, Patsy
dc.date.accessioned2019-06-08T01:32:38Z
dc.date.available2019-06-08T01:32:38Z
dc.date.issued2018
dc.identifier.issn1096-6218
dc.identifier.doi10.1089/jpm.2018.0033
dc.identifier.urihttp://hdl.handle.net/10072/385199
dc.description.abstractBackground: 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.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.relation.ispartofpagefrom1729
dc.relation.ispartofpageto1740
dc.relation.ispartofissue12
dc.relation.ispartofjournalJournal of Palliative Medicine
dc.relation.ispartofvolume21
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode4205
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.titleClinical Indicators That Identify Risk of Deteriorating and Dying in People with a Hematological Malignancy: A Case-Control Study with Multivariable Analysis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorChan, Ray


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