Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand
Issued Date
2022-12-01
Resource Type
eISSN
1472684X
Scopus ID
2-s2.0-85133024786
Pubmed ID
35754048
Journal Title
BMC Palliative Care
Volume
21
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Palliative Care Vol.21 No.1 (2022)
Suggested Citation
Monsomboon A., Chongwatcharasatit T., Chanthong P., Chakorn T., Prapruetkit N., Surabenjawong U., Limsuwat C., Chaisirin W., Ruangsomboon O. Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand. BMC Palliative Care Vol.21 No.1 (2022). doi:10.1186/s12904-022-01009-z Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85289
Title
Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand
Author's Affiliation
Other Contributor(s)
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.