Deaths in critical care and hospice—prevalence, trends, influences: a national decedent cohort study

Mayes, J., McLachlan, S., Carduff, E., McPeake, J. , Boyd, K., Pattison, N. and Lone, N. (2021) Deaths in critical care and hospice—prevalence, trends, influences: a national decedent cohort study. BMJ Supportive and Palliative Care, (doi: 10.1136/bmjspcare-2021-003157) (PMID:34380665) (Early Online Publication)

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Abstract

Objectives: End-of-life and bereavement care support services differ in critical care and inpatient hospice settings. There are limited population-level data comparing deaths in these two locations. We aimed to compare the characteristics of people who die in critical care units and in hospices, identify factors associated with place of death and report 12-year trends in Scotland. Methods: We undertook a cohort study of decedents aged ≥16 years in Scotland (2005–2017). Location of death was identified from linkage to the Scottish Intensive Care Society Audit Group database and National Records of Scotland Death Records. We developed a multinomial logistic regression model to identify factors independently associated with location of death. Results: There were 710 829 deaths in Scotland, of which 36 316 (5.1%) occurred in critical care units and 42 988 (6.1%) in hospices. As a proportion of acute hospital deaths, critical care deaths increased from 8.0% to 11.2%. Approximately one in eight deaths in those aged under 40 years occurred in critical care. Factors independently associated with hospice death included living in less deprived areas, cancer as the cause of death and presence of comorbidities. In contrast, liver disease and accidents as the cause of death and absence of comorbidities were associated with death in critical care. Conclusions: Similar proportions of deaths in Scotland occur in critical care units and hospices. Given the younger age profile and unexpected nature of deaths occurring in critical care units, there is a need for a specific focus on end-of-life and bereavement support services in critical care units.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Carduff, Dr Emma and Mayes, Dr Jonathan and McPeake, Dr Jo
Authors: Mayes, J., McLachlan, S., Carduff, E., McPeake, J., Boyd, K., Pattison, N., and Lone, N.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:BMJ Supportive and Palliative Care
Publisher:BMJ Publishing Group
ISSN:2045-435X
ISSN (Online):2045-4368
Published Online:11 August 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMJ Supportive and Palliative Care 2021
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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