Accident and emergency presentations in patients in their last year of life

Abstract

Presentation of patients with incurable, terminal illness to the emergency department (ED) may prove distressing for patient and caregivers alike. The last year of life has been widely used as a proxy for patients with palliative needs. This retrospective study is the first local study to determine how many patients presenting to the ED are in their last year of life, and thus by association, what percentage of patients presenting to the emergency department would require palliative care. In Malta, 16.66% of patients presenting to the ED were in their last year of life, and despite this value being lower in comparison to overseas, it is still significant keeping in mind that locally palliative care caters only for oncology cases. There was no observed gender difference, and the mean age was of 77.6 years. Most patients presented more than one time to the ED more than once, and the largest cohort of patients presented 3 times to the ED in their last year of life. Community- based palliative care has been shown to reduce presentations to the emergency department and our focus must therefore shift towards strengthening this field.