Diagnosing dying in the acute hospital setting.

摘要

Editor - Gibbins and colleagues show that providing end-of-life care is a challenge in hospitalised patients (Clin Med April 2009 pp 116-9). We conducted a similar audit in acute medical patients and reviewed case notes of 50 patients who died following admission to the department. We excluded patients who died within seven days of admission as we felt that the clinical uncertainty during this period would be very high. Our results are similar to the findings in the article with 62% (31/50) of patients being identified as having end-stage disease and only 54% (17/31) of them being offered end-of-life care. The Liverpool Care Pathway (LCP) was used in 13 patients. Five of these also received specialist palliative care input. Four patients had specialist palliative care input without the use of the LCP.