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- Title
Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea.
- Authors
Kim, Jung Sun; Lee, Sun Young; Lee, Min Sung; Yoo, Shin Hye; Shin, Jeongmi; Choi, Wonho; Kim, Yejin; Han, Hyung Sook; Hong, Jinui; Keam, Bhumsuk; Heo, Dae Seog
- Abstract
Background: High-quality end-of-life (EOL) care requires both comfort care and the maintenance of dignity. However, delivering EOL in the emergency department (ED) is often challenging. Therefore, we aimed to investigate characteristics of EOL care for dying patients in the ED. Methods: We conducted a retrospective cohort study of patients who died of disease in the ED at a tertiary hospital in Korea between January 2018 and December 2020. We examined medical care within the last 24 h of life and advance care planning (ACP) status. Results: Of all 222 disease-related mortalities, 140 (63.1%) were men, while 141 (63.5%) had cancer. The median age was 74 years. As for critical care, 61 (27.5%) patients received cardiopulmonary resuscitation, while 80 (36.0%) received mechanical ventilation. The absence of serious illness (p = 0.011) and the lack of an advance statement (p < 0.001) were both independently associated with the receipt of more critical care. Only 70 (31.5%) patients received comfort care through opioids. Younger patients (< 75 years) (p = 0.002) and those who completed life-sustaining treatment legal forms (p = 0.001) received more comfort care. While EOL discussions were initiated in 150 (67.6%) cases, the palliative care team was involved only in 29 (13.1%). Conclusions: Patients in the ED underwent more aggressive care and less comfort care in a state of imminent death. To ensure better EOL care, physicians should minimize redundant evaluations and promptly introduce ACP.
- Subjects
SOUTH Korea; MEDICAL quality control; TERMINAL care; HOSPITAL emergency services; ACADEMIC medical centers; TERTIARY care; RETROSPECTIVE studies; ADVANCE directives (Medical care); HOSPITAL mortality; DESCRIPTIVE statistics; TUMORS
- Publication
BMC Palliative Care, 2022, Vol 21, Issue 1, p1
- ISSN
1472-684X
- Publication type
Article
- DOI
10.1186/s12904-022-00988-3