Premium
Patients with life‐limiting illness presenting to the emergency department
Author(s) -
Ragg Michael,
Ragg James,
Milnes Sharyn,
Bailey Michael,
Orford Neil
Publication year - 2020
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.13409
Subject(s) - medicine , interquartile range , emergency department , retrospective cohort study , limiting , cohort , emergency medicine , acute care , demographics , observational study , pediatrics , demography , health care , psychiatry , mechanical engineering , sociology , engineering , economics , economic growth
Objective To examine characteristics, outcomes and flow for patients over the age of 45 years with a life‐limiting illness (LLI) presenting to a regional ED. Methods Retrospective, observational cohort study of patients with LLI in an Australian regional ED over a 15‐day period. Eligible patients were 45 years of age or older who fulfilled criteria for having an LLI. Data included demographics, diagnosis for current presentation, presence of advance care documentation, LLI category, admission and discharge destination from ED, ED and hospital length of stay and outcome for patients admitted to the acute hospital. Results A total of 152 (12%) patients had an LLI. The LLI group were older, had a significantly longer median length of stay in the ED (5.9 [interquartile range 4.0–8.4] vs 3.9 h [interquartile range 2.5–6.3], P < 0.0001) and were less likely to leave the ED within 4 h (26% vs 51.5%, P < 0.0001). Forty‐six percent of patients with an LLI had some form of advanced care documentation. Patients with an LLI were more likely to require hospital admission. In relation to illness trajectory, the frailty/dementia trajectory group had comparatively the longest ED length of stay with less than 10% leaving the ED within 4 h. This group were more likely to be discharged to a residential care facility. Conclusion A significant proportion of patients 45 years or older had an LLI which had implications for their length of ED stay and discharge destination.