scholarly journals Commentary on “Remote Advance Care Planning in the Emergency Department During COVID-19 Disaster: Program Development and Initial Evaluation”

2022 ◽  
Vol 48 (1) ◽  
pp. 7-9
Author(s):  
Jennifer Lynn White ◽  
Judd E. Hollander
2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Ya-Ting Ke ◽  
An-Chi Peng ◽  
Yi-Min Shu ◽  
Min-Hsien Chung ◽  
Kang-Ting Tsai ◽  
...  

Background. The prevalence of geriatric syndromes and the need for hospice care in the emergency department (ED) in Asian populations remain unclear. This study was conducted to fill the data gap. Methods. Using a newly developed emergency geriatric assessment (EGA), we investigated the prevalence of geriatric syndromes and the need for hospice care in older ED patients of a tertiary medical center between September 1, 2016, and January 31, 2017. Results. We recruited a total of 693 patients with a mean age of 78.0 years (standard deviation 8.2 years), comprising 46.6% of females. According to age subgroups, 37.4% of patients were aged 65–74 years, 37.4% were aged 75–84 years, and 25.2% were aged ≥85 years. The prevalence rates of geriatric syndromes were as follows: delirium (11.4%), depression (23.4%), dementia (43.1%), deterioration of activities of daily living (ADL) for <1 year (29.4%), vision impairment (22.2%), hearing impairment (23.8%), sleep disturbance (13.1%), any fall in <1 year (21.8%), polypharmacy (28.7%), pain (35.1%), pressure ulcer (5.6%), incontinence or retention (29.6%), indwelling device or physical restrain (21.6%), nutrition problem (35.7%), frequent use of medical resources (50.1%), lack of advance care planning (84.0%), caregiver problem (4.6%), socioeconomic problem (5.5%), and need for family meeting (6.2%). The need for hospice care was 11.9%. Most geriatric syndromes increased with advancing age except depression, sleep disturbance, polypharmacy, pain, nutrition problem, lack of advance care planning, caregiver problem, and socioeconomic problem. Conclusion. Geriatric syndromes and the need for hospice care were common in the older ED patients. Further studies about subsequent intervention for improving geriatric care are needed.


2021 ◽  
Vol 24 (1) ◽  
pp. 31-39
Author(s):  
Sarah E. Pajka ◽  
Mohammad Adrian Hasdianda ◽  
Naomi George ◽  
Rebecca Sudore ◽  
Mara A. Schonberg ◽  
...  

2017 ◽  
Vol 26 (2) ◽  
pp. 585-588 ◽  
Author(s):  
Maria T. Cruz-Carreras ◽  
Patrick Chaftari ◽  
Jayne Viets-Upchurch

2021 ◽  
Vol 2 (1) ◽  
pp. 65-70
Author(s):  
Mohammad Adrian Hasdianda ◽  
Tamryn F. Gray ◽  
Josephine Lo Bello ◽  
Brittany Ballaron ◽  
Natasha A. Egorova ◽  
...  

2018 ◽  
Vol 56 (6) ◽  
pp. 878-885 ◽  
Author(s):  
Richard E. Leiter ◽  
Miryam Yusufov ◽  
Mohammad Adrian Hasdianda ◽  
Lauren A. Fellion ◽  
Audrey C. Reust ◽  
...  

2017 ◽  
Vol 20 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Timothy F. Platts-Mills ◽  
Natalie L. Richmond ◽  
Eric M. LeFebvre ◽  
Sowmya A. Mangipudi ◽  
Allison G. Hollowell ◽  
...  

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 61-61
Author(s):  
Debra A. Wong ◽  
Tom R. Fitch ◽  
Eric Prommer ◽  
Yu-Hui Chang ◽  
Christopher A. Lipinski

61 Background: Patients with cancer often have complex symptoms and morbidity that prompt frequent Emergency Department visits. The length of stay in the ED for cancer patients exceeds that of patients without cancer. Patients with cancer are also more likely to be admitted, but are often discharged within 72h. Protracted ED visits, extensive investigations, and the burdens of even a short admission may be distressing and may not be aligned with patients’ care goals and preferences. Furthermore, the healthcare resources dedicated to these patients is considerable and has economic implications. We recently established a Supportive Care Infusion Center (SCIC), an on-campus outpatient unit where patients can receive treatments for symptom relief and comfort; they are assured integrated palliative care with routine oncologic care. We believe there is a subset of cancer patients who can be safely transferred from the ED to the SCIC for appropriate care. Methods: We are retrospectively evaluating cancer patients admitted through the ED to validate clinical parameters likely to lead to admission, and also identify any differences between patients admitted for <72h vs >72h. Patients are analyzed based on symptoms, cancer type, prior cancer therapies, performance status, comorbidities, and presence/absence of advance care planning as well as previous contact with Palliative Care. Data are also being gathered on patient outcomes, including mortality within 60d of admission. Results: Previously established indicators predictive of admission included shortness of breath and SIRS criteria, which our current review validates. We also observe that patients admitted for >72h have greater symptom burden and comorbidities and have received multiple lines of therapy. They also less frequently have advance care planning in place. Data analysis is ongoing. Conclusions: There exists a difference between cancer patients admitted >72h and those discharged within 72h. Awareness of these characteristics may lead to improved workflow in the ED. Identifying patients who may be suitable for transfer to an outpatient supportive care unit rather than short-term admission will also facilitate cost-effectiveness. Future direction includes evaluation of outcomes such as mortality, quality of life, and patient-caregiver satisfaction.


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