Investigating emergency admissions to hospital
24th July 2017
Researchers at the Cicely Saunders Institute have been investigating emergency admissions to hospital for patients with cancer. The research is part of the BuildCare programme funded by The Atlantic Philanthropies via Cicely Saunders International.
Emergency department visits towards the end of life by cancer patients are increasing over time. This is despite evidence that these admissions lead to poor outcomes for patients and caregivers. Research shows that most patients prefer home-based care.
The researchers set out to identify the factors associated with end-of-life emergency department visits. They wanted to determine the relationship between patients’ prior emergency department use and risk of multiple (more than 2) visits in the last month of life.
In this large-scale national study, researchers analysed the A&E visit pattern by over 120,000 cancer decedents. They found patients with greater comorbidity, lung or head and neck cancer and a higher number of previous emergency department visits are more likely to visit the emergency department multiple times in the last month of life. Previously reported socio-demographic factors (men, younger age, Black, low socio-economic status) are also confirmed for the first time in a UK population.
Among 124,030 cancer decedents (52.9% men; mean age: 74.1 years), 30.7% visited the emergency department once in their last month of life and 5.1% visited multiple times. Patients were more likely to visit multiple times if they were men, younger, Asian or Black, of lower socio-economic status, had greater comorbidity, and lung or head and neck cancer.
Patients with more than 4 emergency department visits in the 11 months prior to their last month of life were also more likely to make multiple visits during their last 30 days.
Henson LA, Higginson IJ, Gao W; BuildCARE. What factors influence emergency department visits by patients with cancer at the end of life? Analysis of a 124,030 patient cohort. Palliat Med. 2017 Jun 1:269216317713428. doi: 10.1177/0269216317713428. [Epub ahead of print]