56
 QUALITY OF END-OF-LIFE CARE 
 OF PATIENTS WITH LYMPHOMA: 
 A RETROSPECTIVE ANALYSIS
 Žnidarič T
1
, Toplak M
1
, Zavratnik B
2
, Červek J
2
 
1
Univerzt e tni	Klinični	Cen t er	Maribor ,	
2
Onk ološki	inš titut	Ljubljana
Introduction: Available data regarding the quality of end-of-life care for patients 
with hematologic malignancies is relatively scarce. That is also the case at the Insti-
tute of Oncology Ljubljana (OI) and country, while multiple analyses were carried 
out concerning solid malignancies.
Methods: 53 patients with lymphoma that died at OI in 2014 were included in the 
study. The quality of care in the final 30 days was assessed by using the following 
indicators of inappropriate, aggressive treatment in that period: days of hospitaliza-
tion, intensive care unit (ICU) admissions, share of deaths at the ICU and systemic 
cancer therapy (SCT) use. Indicators of predicted survival, which enable recognition 
of the end-of-life condition, were also analyzed. The results were compared with 
the available data on quality of care of patients with solid tumors. 
Results: In the final 30 days, 28 out of 53 patients (52,8% vs. 43,1%) received SCT, 
15(28,3 % vs. 5,9 %) were treated at the ICU, 11(20,8% vs. 3,5 %) also died at the 
ICU. There were on average 20,2 days (vs. 13,0 days) of hospitalization. The analy-
sis showed that most of the patients had indicators of short survival (presence of 
systemic chronic inflammation): 31 out of 36 patients (86,1%) had albumins below 
35 g/l, 51 out of 52 patients (96,2%) had CRP over 10 g/l. Glasgow index (GI) could 
be determined for only 35 patients. 2(5,7%) had GI 0, 4(11,4%) had GI 1, and 
30(85,7%) had GI 2. WHO performance status (PS) was noted for 36 patients, PS 
was 2 or less for 12 33,3% vs. 78%) PS 3 or 4 for 24(66,7% vs. 22%). Only 8 patients 
were included in palliative care (15,1% vs. 5,9 %). End-of-life patients also received 
blood replacement products: red blood cells in 50,9%, platelets in 34%, and fresh 
frozen plasma in 8% of the cases. 81,1% of the patients received antibiotic treat-
ment.
Conclusion: The results shows that patient care was carried out according to princi-
ples of standard curative medicine, including frequent laboratory tests, administra-
tion of numerous medications, and the continuation of SCT, in spite of the presence 
of objective indicators of irreversible damage to vital systems. At that stage that 
kind of treatment is pointless and harmful, while symptoms, psychosocial needs of 
the patients and their close ones in the end-of-life period are not considered.