Chapter 4 76 RESULTS Patient and disease characteristics Seventy-eight HM-patients and 420 ST-patients died within three months after their EDvisit (Table 1); more men were in the HM-group (68% versus 55% of ST-patients, p=0.026), median age was 63 years (range: 22-94 years). ECOG-performance score did not differ between HM- and ST-patients. Acute myeloid leukaemia and multiple myeloma were the most common HM-types (26% and 17%, respectively); most solid tumours were located in the digestive tract (27.6%) and in the lung (16.0%; Appendix 1). Before the ED-visit, limitations on life-sustaining treatments (LSTs) were discussed with 171 patients (34.3%): with 13 (16.7%) HM-patients and 158 (37.6%) ST-patients (p<0.0001). Four (5.1%) HMpatients and 142 ST-patients (33.8%) had documented limitations; ‘no limitations’ were documented in 9 (11.5%) HM-patients and 16 (3.8%) ST-patients (p<0.0001). Up to three months before the ED-visit, the PCCT was consulted in 27 patients (1 HM-patient and 26 ST-patients, p=0.10). Communication via letters, telephone and transfers between medical specialists and the patient ’s GP had occurred in 67 (85.9%) HM-patients and 332 (79.0%) ST-patients (p=0.15). Proactive care plans were documented for 13 (16.7%) HM-patients and 66 (15.7%) ST-patients (p=0.83). Table 1. Characteristics of 78 patients with a haematological malignancy and 420 patients with a solid tumour visiting the emergency department. Characteristics Total n=498 HM-patients n=78 ST-patients n=420 n (%) n (%) n (%) P-value Male 282 (56.6) 53 (67.9) 229 (54.5) 0.026 Age in years, median (range) 63 (22-94) 61 (27-94) 61 (22-92) 0.147 Disease-modifying treatment in the past 3 monthsa Chemotherapy 202 (40.6) 34 (43.4) 168 (40.0) 0.554 Radiotherapy 118 (23.7) 14 (17.9) 104 (24.8) 0.182 Targeted therapy/immunotherapy 96 (19.3) 21 (26.9) 75 (17.9) 0.065 Stem-cell transplantation 10 (2.0) 9 (11.5) 1 (0.2) <0.0001 None 125 (25.1) 14 (17.9) 111 (26.4) 0.102 Limitations on LSTsb <0.0001 Discussed, no documented limitations 25 (5.0) 9 (11.5) 16 (3.8) Discussed, documented limitations 146 (29.3) 4 (5.1) 142 (33.8) Not discussed 327 (65.7) 65 (83.3) 262 (62.4)
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