Deaths during or shortly after emergency department care are common, particularly among older patients with comorbidities, according to a study published online Nov. 4 in JAMA Network Open.
Jonathan Elmer, M.D., from the University of Pittsburgh, and colleagues used the Optum all-age, all-payer national database (2010 to 2020) to assess the frequency of death in the emergency department or within one month of an emergency visit. The analysis included 104 million individuals with 96 million emergency encounters.
The researchers found that emergency department deaths accounted for 11.3 percent of total deaths and 33.2 percent of all decedents who visited the emergency department within one month of their death. While the proportion of total national deaths occurring in the emergency department decreased by 0.27 percent annually during the study period, the proportion who died within one month of an emergency visit increased by 1.2 percent annually. Patients with an emergency department death were older, more likely to be White, male, and not Hispanic, and had a higher Charlson Comorbidity Index.
“Robust systems of emergency care must not only offer life-prolonging interventions, but also identify patients and families for whom end-of-life care is necessary or preferred,” the authors write. “The frequency with which these scenarios arise suggests a significant public health impact from policies and resources to support delivery of this care in the emergency department.”
Jonathan Elmer et al, Death and End-of-Life Care in Emergency Departments in the US, JAMA Network Open (2022). DOI: 10.1001/jamanetworkopen.2022.40399
JAMA Network Open
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