title: Emergency Department Visits at the End of Life of Patients With Terminal Cancer: Pattern, Causes, and Avoidability.
abstract: Frequent emergency department visits (EDVs) by patients with terminal cancer indicates aggressive care. The pattern and causes of EDVs in 154 patients with terminal cancer were investigated. The EDVs that started during working hours and ended by home discharge were considered avoidable. During the last 3 months of life, 77% of patients had at least 1 EDV. In total, 309 EDVs were analyzed. The EDVs occurred out of hour in 67%, extended for an average of 3.6 hours, and ended by hospitalization in 52%. The most common chief complaints were pain (46%), dyspnea (13%), and vomiting (12%). The EDVs were considered avoidable in 19% of the visits. The majority of patients with terminal cancer visit the ED before death, mainly because of uncontrolled symptoms. A significant proportion of EDVs at the end of life is potentially avoidable.
authors: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt alsirafy@kasralainy.edu.eg.
authors: Samy A
authors: SA
authors: Alsirafy
authors: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Department of Medical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
authors: Ahmad A
authors: AA
authors: Raheem
authors: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia.
authors: Abdullah S
authors: AS
authors: Al-Zahrani
authors: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Department of Medical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
authors: Amrallah A
authors: AA
authors: Mohammed
authors: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
authors: Mohamed A
authors: MA
authors: Sherisher
authors: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Department of Clinical Oncology, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.
authors: Amr T
authors: AT
authors: El-Kashif
authors: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia.
authors: Hafez M
authors: HM
authors: Ghanem
mesh_terms: D000293:Adolescent; D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D059408:Pain Management; D012189:Retrospective Studies; D012529:Saudi Arabia; D013727:Terminal Care / Q000706:statistics & numerical data*; D014839:Vomiting / Q000209:etiology / Q000628:therapy; D055815:Young Adult
keywords: avoidable; emergency department; end of life; pain; palliative care; symptoms; terminal cancer