AI Article Synopsis
- The study analyzes the characteristics and outcomes of patients referred to an emergency department end-of-life service at a hospital in Hong Kong.
- The research involved assessing 830 patients to determine who was in the dying phase, with 783 recognized as such, and compared their demographics and care to those not in the dying phase.
- Results showed that patients in the end-of-life group had a much shorter time-to-death (around 39 hours) compared to the non-end-of-life group (about 250 hours), with the end-of-life service providing more effective symptomatic treatments.
- The findings suggest that emergency physicians can effectively identify and manage dying patients, highlighting the need for them to take a more active role in end-of-life care.
Article Abstract
Background: This study describes the characteristics and outcomes of patients referred to an emergency department (ED)-based end-of-life (EOL) service in a tertiary acute hospital in Hong Kong. We examine how emergency physicians (EPs) perform in recognizing and managing dying patients.
Methods: From September 2010 to April 2018, patients referred to this EOL service in this hospital were included. A group of 5 EPs assessed whether the referred patient would die within a few days. Dying patients (EOL group) were admitted to ED-based EOL service whereas those not likely dying within few days (non-EOL group) would continue management in respective specialty wards. Baseline characteristics of these 2 groups were compared. The time-to-death and use of opioids and anticholinergics were compared.
Results: In total, 783 of 830 patients assessed were recognized as being in dying phase, with 688 admitted under ED-based EOL care. Their demographics and characteristics were described. Mean time from assessment to death (time-to-death) was significantly less in EOL group (38.93 hours) than in non-EOL group (250.36 hours; = .004). Mean time-to-death was not significantly different between those under EP-based EOL service or not. The ED-based EOL care had significantly more patients receiving symptomatic treatment.
Interpretation: The characteristics of patients under an ED-based EOL service are described. Emergency physicians are capable of recognizing dying patients. Emergency department-based EOL service does not alter the dying process and offers adequate palliation of symptoms. Emergency physician should assume a more active role in providing adequate EOL care to suitable patients.
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| http://dx.doi.org/10.1177/1049909120926148 | DOI Listing |
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