Emergency Department Use at End of Life Among Cancer Patients

There has been increasing interest in describing emergency department (ED) use by cancer patients at the end of life (EOL) over the past decade. Many consider it to be an indicator of quality of EOL care with endorsement from patients, providers, and healthcare systems. The frequency of ED visits at EOL varies depending on the patients studied, methods used for measurement, and window of observation. Most authors conclude that ED visits at EOL are more frequent than is desirable. Common reasons for visits include worsening symptoms, progressive malignancy, or treatment-related toxicity. Factors associated with ED visits are variably reported, but include sex, age, and comorbidity. It is unrealistic to expect that no patient will ever visit the ED at the EOL; however, consistent and early use of comprehensive palliative care services is likely to decrease ED visits at EOL.