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

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. We conducted a retrospective coho...

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Published in:BMC palliative care 2022-06, Vol.21 (1), p.105-11, Article 105
Main 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
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Language:English
Subjects:
Advance Care Planning
Advance directives
Aged
Coronaviruses
COVID-19
Decision making
Disease-related deaths
Emergency department
Emergency service
Emergency Service, Hospital
End-of-life care
Ethical aspects
Female
Hospice care
Hospitals
Humans
Male
Management
Medical care
Mortality
Neoplasms - therapy
Palliative care
Quality management
Retrospective Studies
Terminal Care
Tertiary Care Centers
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creator Kim, Jung Sun
Lee, Sun Young
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Keam, Bhumsuk
Heo, Dae Seog
description 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. 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. 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 
doi_str_mv 10.1186/s12904-022-00988-3
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Younger patients (&lt; 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%). Patients in the ED underwent more aggressive care and less comfort care in a state of imminent death. 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subjects Advance Care Planning
Advance directives
Aged
Coronaviruses
COVID-19
Decision making
Disease-related deaths
Emergency department
Emergency service
Emergency Service, Hospital
End-of-life care
Ethical aspects
Female
Hospice care
Hospitals
Humans
Male
Management
Medical care
Mortality
Neoplasms - therapy
Palliative care
Quality management
Retrospective Studies
Terminal Care
Tertiary Care Centers
title Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea
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