Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand
Abstract Background The characteristics and outcomes of palliative patients who visited the Emergency Department (ED) in Thailand, a country in which no standard palliative care system existed, have not been comprehensively studied. We aimed to report the characteristics of ED palliative patients an...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-06-01
|
| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-022-01009-z |
| _version_ | 1818470861409091584 |
|---|---|
| author | Apichaya Monsomboon Trisuchon Chongwatcharasatit Pratamaporn Chanthong Tipa Chakorn Nattakarn Prapruetkit Usapan Surabenjawong Chok Limsuwat Wansiri Chaisirin Onlak Ruangsomboon |
| author_facet | Apichaya Monsomboon Trisuchon Chongwatcharasatit Pratamaporn Chanthong Tipa Chakorn Nattakarn Prapruetkit Usapan Surabenjawong Chok Limsuwat Wansiri Chaisirin Onlak Ruangsomboon |
| author_sort | Apichaya Monsomboon |
| collection | DOAJ |
| description | Abstract Background The characteristics and outcomes of palliative patients who visited the Emergency Department (ED) in Thailand, a country in which no standard palliative care system existed, have not been comprehensively studied. We aimed to report the characteristics of ED palliative patients and investigate factors associated with mortality. Methods A prospective observational study was conducted at Siriraj Hospital, Bangkok, Thailand, between March 2019 and February 2021 by means of interviewing palliative patients and/or their caregivers and medical record review. Palliative patients with either incurable cancer or other end-stage chronic diseases were included. Results A total of 182 patients were enrolled. Their mean age was 73 years, 61.5% were female, and 53.8% had incurable cancer. Of these, 20.3% had previously visited the palliative clinic. Approximately 60% had advanced directives, 4.9% had a living will, and 27.5% had plans on their preferred place of death. The most common chief complaint was dyspnea (43.4%), and the main reason for ED visits was ‘cannot control symptoms’ (80%). At the ED, 17% of the patients had been seen by the palliative care team, and 23.1% died. Although 51% were admitted, 48.9% could not survive to discharge. Cancer, having received morphine, a palliative performance scale > 30, and ED palliative consultation were independently associated with hospital mortality. Conclusion The recognition and utilization of palliative care were largely inadequate, especially for non-cancer patients. An improvement and promotion in the palliative care system from the ED through home care are mandatory to improve the quality of life of palliative patients. |
| first_indexed | 2024-04-13T21:42:19Z |
| format | Article |
| id | doaj.art-2001c08eff00440c9e45421704d9211f |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-13T21:42:19Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-2001c08eff00440c9e45421704d9211f2022-12-22T02:28:41ZengBMCBMC Palliative Care1472-684X2022-06-012111910.1186/s12904-022-01009-zCharacteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in ThailandApichaya Monsomboon0Trisuchon Chongwatcharasatit1Pratamaporn Chanthong2Tipa Chakorn3Nattakarn Prapruetkit4Usapan Surabenjawong5Chok Limsuwat6Wansiri Chaisirin7Onlak Ruangsomboon8Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversityDepartment of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversitySiriraj Palliative Care Center, Mahidol UniversityDepartment of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversityDepartment of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversityDepartment of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversityDepartment of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversityDepartment of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversityDepartment of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol UniversityAbstract Background The characteristics and outcomes of palliative patients who visited the Emergency Department (ED) in Thailand, a country in which no standard palliative care system existed, have not been comprehensively studied. We aimed to report the characteristics of ED palliative patients and investigate factors associated with mortality. Methods A prospective observational study was conducted at Siriraj Hospital, Bangkok, Thailand, between March 2019 and February 2021 by means of interviewing palliative patients and/or their caregivers and medical record review. Palliative patients with either incurable cancer or other end-stage chronic diseases were included. Results A total of 182 patients were enrolled. Their mean age was 73 years, 61.5% were female, and 53.8% had incurable cancer. Of these, 20.3% had previously visited the palliative clinic. Approximately 60% had advanced directives, 4.9% had a living will, and 27.5% had plans on their preferred place of death. The most common chief complaint was dyspnea (43.4%), and the main reason for ED visits was ‘cannot control symptoms’ (80%). At the ED, 17% of the patients had been seen by the palliative care team, and 23.1% died. Although 51% were admitted, 48.9% could not survive to discharge. Cancer, having received morphine, a palliative performance scale > 30, and ED palliative consultation were independently associated with hospital mortality. Conclusion The recognition and utilization of palliative care were largely inadequate, especially for non-cancer patients. An improvement and promotion in the palliative care system from the ED through home care are mandatory to improve the quality of life of palliative patients.https://doi.org/10.1186/s12904-022-01009-zPalliative carePalliative patientAdvance care planEmergency department visit |
| spellingShingle | Apichaya Monsomboon Trisuchon Chongwatcharasatit Pratamaporn Chanthong Tipa Chakorn Nattakarn Prapruetkit Usapan Surabenjawong Chok Limsuwat Wansiri Chaisirin Onlak Ruangsomboon Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand BMC Palliative Care Palliative care Palliative patient Advance care plan Emergency department visit |
| title | Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand |
| title_full | Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand |
| title_fullStr | Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand |
| title_full_unstemmed | Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand |
| title_short | Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand |
| title_sort | characteristics and factors associated with mortality in palliative patients visiting the emergency department of a large tertiary hospital in thailand |
| topic | Palliative care Palliative patient Advance care plan Emergency department visit |
| url | https://doi.org/10.1186/s12904-022-01009-z |
| work_keys_str_mv | AT apichayamonsomboon characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT trisuchonchongwatcharasatit characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT pratamapornchanthong characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT tipachakorn characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT nattakarnprapruetkit characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT usapansurabenjawong characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT choklimsuwat characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT wansirichaisirin characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand AT onlakruangsomboon characteristicsandfactorsassociatedwithmortalityinpalliativepatientsvisitingtheemergencydepartmentofalargetertiaryhospitalinthailand |