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Emergency Department Use at End of Life

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Oncologic Emergency Medicine

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Abstract

There has been an increasing interest in describing emergency department (ED) use by cancer patients at the end of life (EOL) over the past two decades. Patients, providers, and healthcare administrators have endorsed ED visits in the last weeks of life as an indicator of poor quality of EOL care. Depending on the patients studied, methods used for measurement, and window of observation, ED visits ranged from 1.5% having two or more ED visits in the last 30 days of life to 85% having an ED visit in the last 6 months of life. Most authors conclude that ED visits at EOL are occurring more frequently than is desirable. Common reasons for visits include worsening symptoms, progressive malignancy, and treatment-related toxicity. Factors associated with ED visits vary based on sex, age, and comorbidity. It is unrealistic to expect that no patient will ever visit the ED at the EOL; however, consistent and early use of comprehensive palliative care services is likely to decrease visits at EOL.

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Authors and Affiliations

  1. Department of Oncology, McMaster University, Hamilton, ON, Canada

    Hsien Seow

  2. Department of Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada

    Kayla McMillan

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  1. Hsien Seow
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Correspondence to Hsien Seow .

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Editors and Affiliations

  1. Former Professor and Founding Chair (Retired), The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Knox H. Todd

  2. Professor and Chair, Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA

    Charles R. Thomas, Jr.

  3. Professor and Chair, Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kumar Alagappan

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Seow, H., McMillan, K. (2021). Emergency Department Use at End of Life. In: Todd, K.H., Thomas, Jr., C.R., Alagappan, K. (eds) Oncologic Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-67123-5_55

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