Characteristics of deaths in a department of oncohaematology within a general hospital - A study of 81 cases

We aimed to perform a prospective analysis of the main characteristics of d eaths occurring in the oncohaematology department of a general hospital. Fr om November 1995 to February 1997, a total of 81 patients died in our unit, 50 of whom (61.7%) were male. Their mean age was 67.8 (range 19-96) years. Underlying diseases were: multiple myeloma (9 cases), acute myeloid leukae mia (22). lymphoma (14), chronic lymphocytic leukaemia (6), acute lymphobla stic leukaemia (4), myelodysplastic syndromes (3), solid tumours (11), and other (12. The previous disease duration ranged from 5 days to 276 months ( mean 31.9 months). The duration of the last hospital stay varied between 0 (death on arrival or on way to hospital) and 40 days (mean 9.3 days). Two p atients died in the emergency unit just before entering our department (1 s uicide). Only 15 patients had been admitted for the first time. In 70% of t hese cases death appeared predictable, as the consequence of refractory or endstage disease. In these cases, all the "do not resuscitate" orders were in place at least 48 h before death. About half the patients died without a ny relative present. The frequencies of the clinical complaints evaluated w ere the following: pain necessitating opiates 27%, infection- or disease-re lated fever 40%; dyspnoea 44%; haemorrhage 20%; CNS disturbances 25%. The p ercentages of use of therapy tools chosen as indicators were: benzodiazepin es 80%: chemotherapy 46%, anti-infectious agents 47%; transfusions 42%; maj or analgesics 27%; and steroids 40%. The circumstances and quality of patie nt deaths must be regularly evaluated so that palliative care in the final stages of life can be improved.