P102 | A NEW MODEL FOR MANAGEMENT OF COMPLICATIONS IN FRAIL HEMATOLOGICAL PATIENTS ON TREATMENT: VILLA BETANIA EXPERIENCE.

Due to new biological drugs and to the consequent prolonged response to treatment and survival, more and more hematological patient (pt) nowadays are cared on ambulatory and day hospital regimen. We are witnessing a progressive chronicization of many diseases causing increased needs of health by people affected by hematological disease, and most of them, when become sick or there is a complication, contact their doctor or the closest emergency room. Often, our town hospitals are very crowd and short of bed in an ward appropriate for the aged, frail, hematological patient who is forced to remain hours or days in the emergency corridors with the increased risk of infection when not of delayed cure. For this background, in our department of Internal Medicine we organized a definite section for the assistance of this typology of pts. Patients: From 01/2022 to 12/2024, 248 pts (116M, 132F) with median age 76.4 yrs (range 30 – 90) were admitted to our ward, forwarded by various Hematology Department or by the Emergency Departments of General Hospitals of Rome. The admittance procedure provided patient admission in our ward in 12-72h since the invoiced request by the proposing hospital. Patient typology: during the study period, our hospital received (mail or fax) 248 requests for admitting pts affected by hematologic disease or complications of hematologic therapy or appearance of comorbidity or their getting worse as diabetes, cardiac failure, second primary neoplasm, sepsis or other infections, hemorrhages, etc. Pts characteristics are shown in Table. All admitted pts were assisted with appropriate therapies according to the specific complications or complaints (replacement or supportive therapy, antibiotics, hydration, etc.). The main reason for hospitalization were infections (36.3%) or cardio-vascular diseases (12%). Median time of hospitalization was 10 days (1-38). Of all pts 196 (80%) were referred back to their Hematological Center; 30 (21.1%) were sent to long-term or rehabilitation hospitalization or others specialistic department; 9 pts (3.6%) were referred back to an emergency room for complications during hospitalization; 10 (4%) died in our ward and 3 (1.2%) were entrusted to the Hospice. Conclusions: According to our pilot experience, in our town context, a similar organization seems to promote a more appropriate pt assistance by lightening the burden on both hematologist and emergency doctors, reducing treatment costs. The majority of pts returned to their reference haematologists and quickly resumed specific treatment. Only 4% died during the hospitalization. During our experience we have gained the conviction that a similar path could ameliorate the frail, haematological patients care