{"title":"End-of-life care in a major UK trauma centre.","authors":"Sarah Edwards, Nicola Ubayasiri","doi":"10.1136/spcare-2025-005421","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Death occurs within the emergency department (ED) sadly not infrequently. There is limited evidence exploring the demographics of these patients and the experience they have in the ED when they die or are approaching the end of life (EOL).</p><p><strong>Methods: </strong>A retrospective review of patients aged 18 years and over who died in our major trauma centre was conducted. Data collected included demographics, frailty scores, time of arrival, time of death, time of EOL decision, cause of death in the ED and who wrote do not attempt cardiopulmonary resuscitation (DNACPR) forms.</p><p><strong>Results: </strong>From January to December 2023, 326 patients died in the ED. 76% of patients were aged 65 years or over, with 69% having a clinical frailty score of 5 or more. The average time from arrival to death was 5 hours 56 min, with the average time from EOL decision to death being 1 hour and 53 min. 60% of all patients had a DNACPR, with 75% of those being written by ED clinicians.</p><p><strong>Conclusion: </strong>EOL is becoming ever more important in the ED. Further work is needed to see if our local experience matches other EDs.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Supportive & Palliative Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/spcare-2025-005421","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Death occurs within the emergency department (ED) sadly not infrequently. There is limited evidence exploring the demographics of these patients and the experience they have in the ED when they die or are approaching the end of life (EOL).
Methods: A retrospective review of patients aged 18 years and over who died in our major trauma centre was conducted. Data collected included demographics, frailty scores, time of arrival, time of death, time of EOL decision, cause of death in the ED and who wrote do not attempt cardiopulmonary resuscitation (DNACPR) forms.
Results: From January to December 2023, 326 patients died in the ED. 76% of patients were aged 65 years or over, with 69% having a clinical frailty score of 5 or more. The average time from arrival to death was 5 hours 56 min, with the average time from EOL decision to death being 1 hour and 53 min. 60% of all patients had a DNACPR, with 75% of those being written by ED clinicians.
Conclusion: EOL is becoming ever more important in the ED. Further work is needed to see if our local experience matches other EDs.
期刊介绍:
Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance.
We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication.
In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.