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Abstract
Introduction Fatigue and breathlessness are among the most distressing symptoms for palliative care patients and may be related to underlying anaemia. Red cell concentrate (RCC) transfusion is a common intervention, yet its efficacy in improving these symptoms in palliative populations remains unclear.
Methods This retrospective chart review examined the impact of RCC transfusion on fatigue, breathlessness and functional status in 33 patients admitted to a hospice inpatient unit over 30 months. Symptom and functional scores were assessed pre-transfusion, and at 14 and 30 days post-transfusion, using the Palliative Care Outcomes Collaboration Symptom Assessment Scale, Australian Karnofsky Performance Status (AKPS) and Resource Utilisation Groups–Activities of Daily Living (RUG-ADL) tools.
Results Results showed that fatigue scores improved in 58% of patients, with sustained improvement at 30 days in 36%. A statistically significant reduction in fatigue was observed at 14 days post-transfusion (p=0.02). However, the impact on breathlessness was limited, with only 18% of patients reporting improvement, and no significant changes in mean breathlessness scores over time. Functional status, measured by AKPS and RUG-ADL, declined in 36% and 27% of patients, respectively, likely reflecting the progressive nature of terminal illness.
Conclusions While RCC transfusion demonstrated potential for alleviating fatigue, particularly in the short term, its effects on breathlessness and functional status were limited. The high mortality rate (30% at 30 days) and small sample size highlight the challenges of research in this population. These findings support the role of RCC transfusion in managing fatigue in palliative care, though further prospective studies are warranted.
- Dyspnoea
- Fatigue
- Hospice care
- End of life care
- Haematological disease
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Footnotes
X @https://orcid.org/0000-0002-3571-2951
Contributors GK contributed to study concept and design, data collection and report writing. GK is also the guarantor and accepts full responsibility for the finished work and/or conduct of the study, access to data and decision to publish. CK contributed to data analysis and interpretation. IH contributed to approval for publication. CM contributed to data interpretation, revising draft reports and approval for publication.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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