Background: Many patients with end-stage diseases are in need of optimal physical, spiritual, psychological and social care. Despite efforts to provide community care, those with severe symptoms often present to emergency departments (EDs) with these needs unmet.
Aim: The objective of this study was to identify palliative care (PC) patients and document their unmet end-of-life care (EOLC) needs in EDs. This abstract presents preliminary results regarding the demographics and illnesses of PC patients presenting to EDs.
Methods: This 4 month prospective cohort study was conducted in 2 EDs in Edmonton, Alberta. Each of the volunteer physicians identified PC patients and recorded data on their type of illness, unmet PC needs and their PC referral recommendations based on a modified screening tool to identify patients in need for PC. Adult patients presenting to the 2 ED sites with life-limiting, chronic conditions including cancer, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), heart failure (HF), cirrhosis, dementia and/or progressive central nervous system (CNS) disease, were eligible. Research assistants collected the screening tools daily and entered the data. Descriptive analyses were conducted.
Results: A total of 663 PC patients (over 26328 total ED visits) were enrolled from 45 participating physicians. The prevalence of PC patients varied between 1-5%. There was a higher proportion of females (n=338, 51%), with a median age of 76 (IQR= 63, 85). Cancer was the most prevalent (N=271, 41.3%), followed by dementia (N= 150, 22.9%) and COPD (N= 107, 16.3%); HF, CKD, progressive CNS disease, and cirrhosis, being the least common (all <10%).  
Conclusion/Discussion: Palliative care varied between EDs and cancer remains the most prevalent condition of the PC patients. This study may facilitate the identification of potential deficits in care and serve as a baseline for future studies.


The Prevalence of End-of-Life Conditionsin Two Canadian Emergency Department