scholarly journals Factors Associated With Emergency Department Visits by People With Dementia Near the End of Life: A Systematic Review

2021 ◽  
Author(s):  
Lesley Thoms ◽  
Catherine J. Evans ◽  
Rachel L. Cripps ◽  
Javiera Leniz ◽  
Emel Yorganci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
End Of Life ◽  
Emergency Department Visits ◽  
Factors Associated ◽  
People With Dementia

scholarly journals Factors associated with older people’s emergency department attendance towards the end of life: a systematic review

2018 ◽  
Vol 29 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Anna E Bone ◽  
Catherine J Evans ◽  
Simon N Etkind ◽  
Katherine E Sleeman ◽  
Barbara Gomes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
End Of Life ◽  
Emergency Department Attendance ◽  
Factors Associated

Do Palliative Care Interventions Reduce Emergency Department Visits among Patients with Cancer at the End of Life? A Systematic Review

2014 ◽  
Vol 17 (12) ◽  
pp. 1384-1399 ◽  
Author(s):  
Lisa D. DiMartino ◽  
Bryan J. Weiner ◽  
Deborah K. Mayer ◽  
George L. Jackson ◽  
Andrea K. Biddle
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Palliative Care ◽  
End Of Life ◽  
Emergency Department Visits ◽  
Patients With Cancer

scholarly journals Defining end of life in dementia: A systematic review

2021 ◽  
pp. 026921632110254
Author(s):  
Bria Browne ◽  
Nuriye Kupeli ◽  
Kirsten J Moore ◽  
Elizabeth L Sampson ◽  
Nathan Davies
Keyword(s):  
Systematic Review ◽  
End Of Life ◽  
Healthcare Professionals ◽  
Functional Decline ◽  
Advanced Stage ◽  
Family Carers ◽  
Inclusion Criteria ◽  
Single Measure ◽  
People With Dementia ◽  
Limiting Condition

Background: Dementia is a life-limiting condition that affects 50 million people globally. Existing definitions of end of life do not account for the uncertain trajectory of dementia. People living with dementia may live in the advanced stage for several years, or even die before they reach the advanced stage of dementia. Aim: To identify how end of life in people with dementia is measured and conceptualised, and to identify the factors that contribute towards identifying end of life in people with dementia. Design: Systematic review and narrative synthesis. Data Sources: Electronic databases MEDLINE, EMBASE, PsychInfo and CINAHL, were searched in April 2020. Eligible studies included adults with any dementia diagnosis, family carers and healthcare professionals caring for people with dementia and a definition for end of life in dementia. Results: Thirty-three studies met the inclusion criteria. Various cut-off scores from validated tools, estimated prognoses and descriptive definitions were used to define end of life. Most studies used single measure tools which focused on cognition or function. There was no pattern across care settings in how end of life was defined. Healthcare professionals and family carers had difficulty recognising when people with dementia were approaching the end of life. Conclusion: End-of-life care and research that focuses only on cognitive and functional decline may fail to recognise the complexities and unmet needs relevant to dementia and end of life. Research and clinical practice should adopt a needs-based approach for people with dementia and not define end of life by stage of disease.

Factors associated with bariatric postoperative emergency department visits

2016 ◽  
Vol 12 (10) ◽  
pp. 1826-1831 ◽  
Author(s):  
Ryan Macht ◽  
Judy George ◽  
Omid Ameli ◽  
Donald Hess ◽  
Howard Cabral ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Department Visits ◽  
Factors Associated

scholarly journals Patterns of emergency department attendance among older people in the last three months of life and factors associated with frequent attendance: a mortality follow-back survey

2019 ◽  
Vol 48 (5) ◽  
pp. 680-687
Author(s):  
Anna E Bone ◽  
Catherine J Evans ◽  
Lesley A Henson ◽  
Wei Gao ◽  
Irene J Higginson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Health Professional ◽  
End Of Life ◽  
Respiratory Disease ◽  
Community Support ◽  
Free Text ◽  
Coordinated Care ◽  
Factors Associated ◽  
Increased Risk

Abstract Background frequent emergency department (ED) attendance at the end of life disrupts care continuity and contradicts most patients’ preference for home-based care. Objective to examine factors associated with frequent (≥3) end of life ED attendances among older people to identify opportunities to improve care. Methods pooled data from two mortality follow-back surveys in England. Respondents were family members of people aged ≥65 who died four to ten months previously. We used multivariable modified Poisson regression to examine illness, service and sociodemographic factors associated with ≥3 ED attendances, and directed content analysis to explore free-text responses. Results 688 respondents (responses from 42.0%); most were sons/daughters (60.5%). Mean age at death was 85 years. 36.5% had a primary diagnosis of cancer and 16.3% respiratory disease. 80/661 (12.1%) attended ED ≥3 times, accounting for 43% of all end of life attendances. From the multivariable model, respiratory disease (reference cancer) and ≥2 comorbidities (reference 0) were associated with frequent ED attendance (adjusted prevalence ratio 2.12, 95% CI 1.21–3.71 and 1.81, 1.07–3.06). Those with ≥7 community nursing contacts (reference 0 contacts) were more likely to frequently attend ED (2.65, 1.49–4.72), whereas those identifying a key health professional were less likely (0.58, 0.37–0.88). Analysis of free-text found inadequate community support, lack of coordinated care and untimely hospital discharge were key issues. Conclusions assigning a key health professional to older people at increased risk of frequent end of life ED attendance, e.g. those with respiratory disease and/or multiple comorbidities, may reduce ED attendances by improving care coordination.

scholarly journals Paediatric acute lymphadenitis: Emergency department management and clinical course

2019 ◽  
Vol 25 (8) ◽  
pp. 534-542
Author(s):  
Michelle Long ◽  
Deepti N Reddy ◽  
Salwa Akiki ◽  
Nicholas J Barrowman ◽  
Roger Zemek
Keyword(s):  
Emergency Department ◽  
Antibiotic Use ◽  
Emergency Department Visits ◽  
Surgical Drainage ◽  
Cervical Lymphadenitis ◽  
Intravenous Antibiotic ◽  
Duration Of Symptoms ◽  
Factors Associated ◽  
Emergency Department Management ◽  
Return Visits

Abstract Objectives To describe clinical characteristics and management of acute lymphadenitis and to identify risk factors for complications. Methods Health record review of children ≤17 years with acute lymphadenitis (≤2 weeks) in a tertiary paediatric emergency department (2009–2014); 10% of charts were reviewed by a blinded second reviewer. Multivariate logistic regression identified factors associated with intravenous antibiotic treatment, unplanned return visits warranting intervention, and surgical drainage. Results Of 1,023 health records, 567 participants with acute lymphadenitis were analyzed. The median age = 4 years (interquartile range [IQR]: 2 to 8 years), and median duration of symptoms = 1.0 day (IQR: 0.5 to 3.0 days). Cervical lymphadenitis was most common. Antibiotics were prescribed in 73.5% of initial visits; 86.9% of participants were discharged home. 29.0% received intravenous antibiotics, 19.3% had unplanned emergency department return visits, and 7.4% underwent surgical drainage. On multivariate analysis, factors associated with intravenous antibiotic use included history of fever (odds ratio [OR]=2.07, 95% confidence interval [CI]: 1.11 to 3.92), size (OR=1.74 per cm, 95% CI: 1.44 to 2.14), age (OR=0.84 per year, 95% CI: 0.76 to 0.92), and prior antibiotic use (OR=4.45, 95% CI: 2.03 to 9.88). The factors associated with unplanned return visit warranting intervention was size (OR=1.30 per cm, 95% CI: 1.06 to 1.59) and age (OR=0.89, 95% CI: 0.80 to 0.97). Factors associated with surgical drainage were age (OR=0.68 per year, 95% CI: 0.53 to 0.83) and size (OR=1.80 per cm, 95% CI: 1.41 to 2.36). Conclusions The vast majority of children with acute lymphadenitis were managed with outpatient oral antibiotics and did not require return emergency department visits or surgical drainage. Larger lymph node size and younger age were associated with increased intravenous antibiotic initiation, unplanned return visits warranting intervention and surgical drainage.

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