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Patients with life-limiting illness presenting to the emergency department

Citation

Ragg, M and Ragg, J and Milnes, J and Bailey, M and Orford, N, Patients with life-limiting illness presenting to the emergency department, EMA, 32, (2) pp. 288-294. ISSN 1742-6731 (2020) [Refereed Article]

Copyright Statement

Copyright 2019 Australasian College for Emergency Medicine

DOI: doi:10.1111/1742-6723.13409

Abstract

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.

Item Details

Item Type:Refereed Article
Keywords:cancer, emergency medicine, frailty, life-limiting illness, organ failure
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Paramedicine
Objective Division:Expanding Knowledge
Objective Group:Expanding knowledge
Objective Field:Expanding knowledge in the health sciences
UTAS Author:Ragg, J (Mr James Ragg)
UTAS Author:Milnes, J (Mrs Julie Milnes)
ID Code:139548
Year Published:2020
Deposited By:Medicine
Deposited On:2020-06-22
Last Modified:2021-04-13
Downloads:0

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