NDLI: Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea

Content Provider	Springer Nature : BioMed Central
Author	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.
Related Links	https://bmcpalliatcare.biomedcentral.com/counter/pdf/10.1186/s12904-022-00988-3.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s12904-022-00988-3
Journal	BMC Palliative Care
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2022-06-07
Access Restriction	Open
Subject Keyword	Pain Medicine Quality of Life Research Palliative Medicine End-of-life care Emergency department Disease-related deaths
Content Type	Text
Resource Type	Article
Subject	Medicine
Journal Impact Factor	2.5/2023
5-Year Journal Impact Factor	3.2/2023

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