General Characteristics of Palliative Care Patients Admitted to the Emergency Department

Yıl 2023, Cilt: 5 Sayı: 1, 1 - 8, 29.01.2023

Ahmet Münir Yılmaz , Halil İbrahim Çıkrıklar , Vahide Aslıhan Durak , Burak Kurtoğlu , Serhat Atmaca , Suna Eraybar , Feyzullah Faruk Seçkin Hakan Çelebi , Erol Armagan

https://doi.org/10.46310/tjim.1146947

Öz

Background This study aimed to analyze patients who apply to emergency services and need palliative care regarding appropriate patient care and effective use of health institutions.
Materials and Methods The study was conducted prospectively on patients who applied to the emergency services of Bursa Uludag University Health Application and Research Center, Health Sciences University Bursa Yüksek Ihtisas Training and Research Hospital and Bursa City Hospital between 15.08.2021 and 15.02.2022 and needed palliative care.
Results A total of 261 patients, 143 male (54.8%) and 118 female (45.2%), were included in the study. It was determined that 50 (19.1%) of these patients had previously received palliative care services. It was determined that the patients included in the study applied to the emergency services 7.52±6.77 times in the last year. The three most common diseases diagnosed in patients admitted to the emergency department were pneumonia (24.5%), urinary system infection (7.7%), and cerebrovascular disease (5.4%). Of the patients, 39.84% were referred/hospitalized, 25.28% were referred/hospitalized to intensive care units, 2.68% refused treatment, 2.68% died, and 29.5% have been discharged.
Conclusion As a result, it is understood that most of the patients in need of palliative care do not receive this service, and patients who can be treated in palliative care units are treated in clinics and intensive care units.

Anahtar Kelimeler

Palliative Care, Emergency Department, Terminal Stage

Kaynakça

• Kandarian B, Morrison RS, Richardson LD, Ortiz J, Grudzen CR. Emergency department-initiated palliative care for advanced cancer patients: protocol for a pilot randomized controlled trial. Trials. 2014 Jun 25;15:251. doi: 10.1186/1745-6215-15-251.
• Sepúlveda C, Marlin A, Yoshida T, Ullrich A. Palliative Care: the World Health Organization’s global perspective. J Pain Symptom Manage. 2002 Aug;24(2):91-6. doi: 10.1016/s0885-3924(02)00440-2.
• Connor SR, Bermedo SMC, eds. Alliance global atlas of palliative care at the end of life. World Health Organization 2014. Worldwide Palliative Care Alliance; 2014.
• Reville B, Foxwell AM. The global state of palliative care-progress and challenges in cancer care. Ann Palliat Med. 2014 Jul;3(3):129-38. doi: 10.3978/j.issn.2224-5820.2014.07.03.
• Borasio GD. Translating the World Health Organization definition of palliative care into scientific practice. Palliat Support Care. 2011 Mar;9(1):1-2. doi: 10.1017/S1478951510000489.
• Di Leo S, Alquati S, Autelitano C, Costantini M, Martucci G, De Vincenzo F, Kuczynska B, Morini A, Trabucco L, Ursicelli R, Catania G, Ghirotto L. Palliative care in the emergency department as seen by providers and users: a qualitative study. Scand J Trauma Resusc Emerg Med. 2019 Sep 18;27(1):88. doi: 10.1186/s13049-019-0662-y.
• Lawrenson R, Waetford J, Gibbons V, Kirk P, Haggar S, Reddy R. Palliative care patients’ use of emergency departments. N Z Med J. 2013 Apr 5;126(1372):80-8.
• Akçiçek F, Akbulut G, Fadıloğlu ZÇ, eds. Palyatif Bakım Evde ve Hastanede Çalıştay Raporu 1. baskı. İzmir: Meta Basım Matbaacılık; 2013.
• Miniksar ÖH, Aydın A. Palyatif bakım ünitemizde yatan hastaların retrospektif analizi. J Contemp Med. 2020;10(3):429-33. doi: 10.16899/jcm.624878.
• Bond K, Ospina MB, Blitz S, Afilalo M, Campbell SG, Bullard M, Innes G, Holroyd B, Curry G, Schull M, Rowe BH. Frequency, determinants and impact of overcrowding in emergency departments in Canada: a national survey. Healthc Q. 2007;10(4):32-40. doi: 10.12927/hcq.2007.19312.
• Yürüyen M, Tevetoğlu IÖ, Tekmen Y, Polat Ö, Arslan İ, Okuturlar Y. Palyatif bakım hastalarında klinik özellikler ve prognostik faktörler. Konuralp Tıp Dergisi. 2018;10(1):74-80. doi: 10.18521/ktd.368570.
• Derlet RW, Kinser D, Ray L, Hamilton B, McKenzie J. Prospective identification and triage of nonemergency patients out of an emergency department: a 5-year study. Ann Emerg Med. 1995 Feb;25(2):215-23. doi: 10.1016/s0196-0644(95)70327-6.
• Strömgren AS, Sjogren P, Goldschmidt D, Petersen MA, Pedersen L, Groenvold M. Symptom priority and course of symptomatology in specialized palliative care. J Pain Symptom Manage. 2006 Mar;31(3):199-206. doi: 10.1016/j.jpainsymman.2005.07.007.
• Kaasa S, Torvik K, Cherny N, Hanks G, de Conno F. Patient demographics and centre description in European palliative care units. Palliat Med. 2007 Jan;21(1):15-22. doi: 10.1177/0269216306072086.
• Tsai JS, Wu CH, Chiu TY, Hu WY, Chen CY. Symptom patterns of advanced cancer patients in a palliative care unit. Palliat Med. 2006 Sep;20(6):617-22. doi: 10.1177/0269216306071065.
• Green E, Ward S, Brierley W, Riley B, Sattar H, Harris T. “They shouldn’t be coming to the ED, should they?”: A descriptive service evaluation of why patients with palliative care needs present to the emergency department. Am J Hosp Palliat Care. 2017 Dec;34(10):984-990. doi: 10.1177/1049909116676774.
• Algan R. Examination of palliative care needs in patients applying to emergency department. Unpublished specialty thesis in medicine (supervisor: Kilicaslan I). Gazi University, Faculty of Medicine. Ankara, 2020 (in Turkish).
• Verhoef MJ, de Nijs E, Horeweg N, Fogteloo J, Heringhaus C, Jochems A, Fiocco M, van der Linden Y. Palliative care needs of advanced cancer patients in the emergency department at the end of life: an observational cohort study. Support Care Cancer. 2020 Mar;28(3):1097-107. doi: 10.1007/s00520-019-04906-x.
• Kirkland SW, Garrido Clua M, Kruhlak M, Villa-Roel C, Couperthwaite S, Yang EH, Elwi A, O’Neill B, Duggan S, Brisebois A, Rowe BH. Comparison of characteristics and management of emergency department presentations between patients with met and unmet palliative care needs. PLoS One. 2021 Sep 27;16(9):e0257501. doi: 10.1371/journal.pone.0257501.
• Lawson BJ, Burge FI, Mcintyre P, Field S, Maxwell D. Palliative care patients in the emergency department. J Palliat Care. 2008 Winter;24(4):247-55.
• Leith TB, Haas NL, Harvey CE, Chen C, Ives Tallman C, Bassin BS. Delivery of end-of-life care in an emergency department-based intensive care unit. J Am Coll Emerg Physicians Open. 2020 Sep 27;1(6):1500-4. doi: 10.1002/emp2.12258.
• Yang C, Yang TT, Tsou YJ, Lin MH, Fan JS, Huang HH, Tsai MC, Yen DH. Initiating palliative care consultation for acute critically ill patients in the emergency department intensive care unit. J Chin Med Assoc. 2020 May;83(5):500-6. doi: 10.1097/JCMA.0000000000000297.