title: Imminence of death among hospital inpatients: Prevalent cohort study.
abstract: BACKGROUND
  There is a dearth of evidence on the proportion of the hospital population at any one time, that is in the last year of life, and therefore on how hospital policies and services can be oriented to their needs.
  
  
  OBJECTIVE
  To establish the likelihood of death within 12 months of a cohort of hospital inpatients on a given census date.
  
  
  METHODS
  Prevalent cohort study.
  
  
  METHODS
  In total, 10,743 inpatients in 25 Scottish teaching and general hospitals on 31 March 2010.
  
  
  RESULTS
  In all, 3098 (28.8%) patients died during follow-up: 2.9% by 7 days, 8.9% by 30 days, 16.0% by 3 months, 21.2% by 6 months, 25.5% by 9 months and 28.8% by 12 months. Deaths during the index admission accounted for 32.3% of all deaths during the follow-up year. Mortality rose steeply with age and was three times higher at 1 year for patients aged 85 years and over compared to those who were under 60 years (45.6% vs 13.1%; p < 0.001). In multivariate analyses, men were more likely to die than women (odds ratio: 1.18, 95% confidence interval: 0.95-1.47) as were older patients (odds ratio: 4.99, 95% confidence interval: 3.94-6.33 for those who were 85 years and over compared to those who were under 60 years), deprived patients (odds ratio: 1.17, 95% confidence interval: 1.01-1.35 for most deprived compared to least deprived quintile) and those admitted to a medical specialty (odds ratio: 3.13, 95% confidence interval: 2.48-4.00 compared to surgical patients).
  
  
  CONCLUSIONS
  Large numbers of hospital inpatients have entered the last year of their lives. Such data could assist in advocacy for these patients and should influence end-of-life care strategies in hospital.
authors.affiliation: 1 School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK.
authors.forename: David
authors.initials: D
authors.lastname: Clark
authors.affiliation: 2 Healthcare Information Group, Information Services Division, NHS National Services Scotland, Edinburgh, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Armstrong
authors.affiliation: 3 Department of Public Health, NHS Dumfries & Galloway, Dumfries, UK.
authors.forename: Ananda
authors.initials: A
authors.lastname: Allan
authors.affiliation: 4 Glenkens Medical Practice, New Galloway, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Graham
authors.affiliation: 3 Department of Public Health, NHS Dumfries & Galloway, Dumfries, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Carnon
authors.affiliation: 5 Dumfries and Galloway Royal Infirmary, NHS Dumfries & Galloway, Dumfries, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Isles
keywords: Inpatients; end-of-life care; hospitalisation; mortality; palliative care; social deprivation; terminal care