End-of-life trajectories of patients with haematological malignancies and advanced solid tumours 79 Visit and follow-up characteristics Patients underwent diagnostic imaging in 64.1% and laboratory tests in 84.1% (Table 3). Most patients were diagnosed with infection or fever (24.5%), bronchopulmonary insufficiency (14.3%) or renal insufficiency (11.8%). In HM-patients, treatment for their main symptoms was initiated at the ED more often than in ST-patients (69.2% versus 54.8%, p=0.010). After their ED-visit, more HM-patients were hospitalized than in STpatients (91.0% versus 76.0%, p=0.001). The ED-visit triggered discussions about LSTs in both HM-patients and ST-patients. After the ED-visit, LSTs were documented for 41 (52.6%) HM-patients and 307 (73.1%) ST-patients (p<0.0001). Among these patients, 39 (95.1%) HM-patients and 297 (96.7%) ST-patients had limitations on LSTs (p=0.64). Median survival from the ED-visit was 17 days (95% CI 15-19) and was significantly shorter in HM-patients (15 days versus 18 days, p=0.028). In-hospital death occurred in 67.9% of the HM-patients versus 29.5% of the ST-patients; HM-patients died at home in 15.4% versus 38.3% of the ST-patients (p<0.0001). In HM-patients, causes of death were disease progression (46.2%), treatment toxicity (39.7%), or both (9.0%). Quality of end-of-life care Quality of end-of-life care in HM- and ST-patients is shown in Table 4. Intensive anti-cancer treatment was administered to 375 (72.4%) of all patients up to 6 months before the EDvisit; to 75.6% of the HM-patients versus 71.8% of the ST-patients, p=0.48. HM-patients died more often in-hospital compared to ST-patients (67.9% versus 29.5%, p<0.0001), in an acute hospital setting (29.5% versus 2.7%, p<0.0001) and less often in a hospice (2.6% versus 10.5%, p=0.011). 4
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