• Amy L Sweeny, Nemat Alsaba, Laurie Grealish, Katya May, Ya-Ling Huang, Jamie Ranse, Kerina J Denny, Bill Lukin, Andrew Broadbent, Erin Burrows, Kristen Ranse, Linda Sunny, Meghna Khatri, and Julia Crilly.
• Emergency Department, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.
• Emerg Med Australas. 2024 Feb 1; 36 (1): 132313-23.

ObjectivesTo describe the characteristics of, and care provided to, older people who died within 48 h of ED presentation.MethodsA descriptive retrospective cohort study of people 65 years and older presenting to two EDs in Queensland, Australia, between April 2018 and March 2019. Data from electronic medical records were collected and analysed.ResultsTwo hundred and ninety-five older people who died within 48 h of ED presentation were included. Nearly all arrived by ambulance (92%, n = 272) and 36% (n = 106) were from aged care facilities. Three-quarters (75%, n = 222) were triaged into the most urgent triage categories (i.e. Australasian Triage Scale; ATS 1/2). Fewer than half were previously independent with mobility (38%, n = 111) and activities of daily living (43%, n = 128). Sixty-one per cent (n = 181) had a pre-existing healthcare directive. Twenty-two per cent (n = 66) died in ED, most commonly due to pneumonia, intracerebral haemorrhage, cardiac arrest and/or sepsis. Over half had one or more ED visits (52%, n = 154) and/or hospital admissions (52%, n = 152) 6 months prior.ConclusionsIdentification of patients at end-of-life (EoL) is not always straightforward; consider recent reduction in independence and recent ED visits/hospital admissions. System-based strategies that span pre-hospital, ED and in-patient care are recommended to facilitate EoL pathway implementation and care continuity.© 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.

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