End‐of‐life care: A retrospective cohort study of older people who died within 48 hours of presentation to the emergency department

Author:

Sweeny Amy L123ORCID,Alsaba Nemat13,Grealish Laurie24,May Katya15,Huang Ya‐Ling156,Ranse Jamie125ORCID,Denny Kerina J78ORCID,Lukin Bill89ORCID,Broadbent Andrew310,Burrows Erin1,Ranse Kristen5,Sunny Linda311,Khatri Meghna3,Crilly Julia125ORCID

Affiliation:

1. Emergency Department Gold Coast Hospital and Health Service Gold Coast Queensland Australia

2. Menzies Health Institute Queensland Griffith University Gold Coast Queensland Australia

3. Faculty of Health Sciences and Medicine Bond University Gold Coast Queensland Australia

4. Nursing and Midwifery Research Unit Gold Coast Hospital and Health Service Gold Coast Queensland Australia

5. School of Nursing and Midwifery Griffith University Gold Coast Queensland Australia

6. Faculty of Health (Nursing) Southern Cross University Gold Coast Queensland Australia

7. Department of Intensive Care Medicine Gold Coast Hospital and Health Service Gold Coast Queensland Australia

8. School of Medicine The University of Queensland Brisbane Queensland Australia

9. Royal Brisbane Residential Aged Care Assessment and Referral Service Brisbane Queensland Australia

10. Supportive and Specialist Palliative Care Gold Coast Hospital and Health Service Gold Coast Queensland Australia

11. Lyell McEwin and Modbury Hospitals, Northern Adelaide Local Health Network Adelaide South Australia Australia

Abstract

AbstractObjectivesTo describe the characteristics of, and care provided to, older people who died within 48 h of ED presentation.MethodsA descriptive retrospective cohort study of people 65 years and older presenting to two EDs in Queensland, Australia, between April 2018 and March 2019. Data from electronic medical records were collected and analysed.ResultsTwo hundred and ninety‐five older people who died within 48 h of ED presentation were included. Nearly all arrived by ambulance (92%, n = 272) and 36% (n = 106) were from aged care facilities. Three‐quarters (75%, n = 222) were triaged into the most urgent triage categories (i.e. Australasian Triage Scale; ATS 1/2). Fewer than half were previously independent with mobility (38%, n = 111) and activities of daily living (43%, n = 128). Sixty‐one per cent (n = 181) had a pre‐existing healthcare directive. Twenty‐two per cent (n = 66) died in ED, most commonly due to pneumonia, intracerebral haemorrhage, cardiac arrest and/or sepsis. Over half had one or more ED visits (52%, n = 154) and/or hospital admissions (52%, n = 152) 6 months prior.ConclusionsIdentification of patients at end‐of‐life (EoL) is not always straightforward; consider recent reduction in independence and recent ED visits/hospital admissions. System‐based strategies that span pre‐hospital, ED and in‐patient care are recommended to facilitate EoL pathway implementation and care continuity.

Funder

Emergency Medicine Foundation

Publisher

Wiley

Subject

Emergency Medicine

Reference39 articles.

1. United Nations Department of Economic and Social Affairs Population Division.World Population Ageing 2019: Highlights (ST/ESA/SER.A/430) 2019. [Cited 26 Oct 2022.] Available from URL:https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019‐Highlights.pdf

2. Australian Institute of Health and Welfare.Emergency Department Care 2020–21 data. [Updated 14 Jul 2022; cited 11 Aug 2022.] Available from URL:https://www.aihw.gov.au/reports‐data/myhospitals/sectors/emergency‐department‐care

3. AshmanJJ SchappertSM SantoL.Emergency department visits among adults aged 60 and over: United States 2014–2017. NCHS Data Brief no. 367. Hyattsville MD: National Center for Health Statistics 2020.

4. The growing impact of older patients in the emergency department: a 5-year retrospective analysis in Brazil

5. Emergency department visits in older patients: a population-based survey

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3