Characteristics and Palliative Care involvement in patients dying in five UK emergency departments: a retrospective service evaluation

Introduction: Approximately 600,000 people die every year in the United Kingdom including 24,000 who die in the Emergency Department (ED). The National Audit of Care at the End of Life looks at the care of dying people during their last hospital admission. However, patients who die in the ED are excluded from this audit and therefore little is currently known about this population. Purpose: This service evaluation aimed to describe the population who died in a 12-month period in five NHS EDs, including whether palliative care teams were involved. Patients and methods: Records from all eligible patients in the 12 months from 1 ^st June 2022 were reviewed. Anonymised data from each site was collated and compared. Results: There were 704,303 ED patient presentations across the 5 sites, and 852 deaths. The mean age of death was 74.04 with a slight male preponderance of 56.8%. Between sites there was a wide range (0.4%-25%) of involvement from palliative care with these patients whilst in ED. The overwhelming majority had a medical (rather than surgical or traumatic) cause of death. Conclusion: Research is needed in order to ascertain how care can be improved for this group of patients. More UK-centric work is required to understand the characteristics of patients who die in EDs including their cause of death and ethnicity, as well as an exploration of whether greater palliative care collaboration in ED improves patient, family and staff experience.