Jurnal Internasional Afrika vol.12 issue 4 2022
African Journal of Emergency Medicine
Patients requiring palliative care attending a regional hospital emergency centre in South Africa: A descriptive study

Jurnal Internasional Afrika vol.12 issue 4 2022
African Journal of Emergency Medicine
Patients requiring palliative care attending a regional hospital emergency centre in South Africa: A descriptive study

Emergency centers Palliative care Attendance Reasons Diagnoses Disposition

Background: : Globally, emergency centers (ECs) face increasing patients with palliative care (PC) needs. This is also true for South Africa. Factors include an increasingly older population, rising rates of non-communicable and infectious diseases. A paucity of data exists on local rates and reasons for patients with life limiting conditions presenting to ECs. PC and emergency medicine are established specialties, but little is known how they interface in clinical practice. This study describes the contribution of patients with life limiting conditions to the case load of an EC in a regional hospital in the Western Cape. Methods: : This was a prospective, descriptive study. All patients entering the EC over 3 months were assessed using a validated PC identification tool, developed for low-and-middle-income countries. All patients entering the EC were captured in an electronic database. Those identified to have life limiting illnesses and potential PC needs received a secondary ICD-10 code. These files were extracted and statistically analysed. Variables included diagnosis, demographics, reason for visit, and disposition. Results: : A total of 426 patient visits (4.24%) were identified. Cancer (25.8%), neurological (19.7%) and HIV (17.4%) were the most frequent diagnoses. Patients with HIV and TB were significantly younger. Physical symp- toms were the most common reasons for attendance (87%), followed by social (11%) and system issues (10%). Most patients were discharged home (55%), 26% were admitted, and 13% died in the EC. Discussion: : ECs in Africa are under-resourced and uncomfortable places for patients with life limiting illnesses. System-related visits could be avoidable, as most were due to patients running out of medication or requiring procedures such as urinary catheter changes, which could be done at the local clinic. Some attended EC due to social reasons, usually due to caregivers feeling overwhelmed. Patients requiring PC make up a significant percentage of EC visits. Optimizing health systems and community home-based care could alleviate EC pressures and improve the illness experience of patients with life limiting conditions.
Background
According to the World Health Organization (WHO), palliative care (PC) aims to improve the quality of life for patients and their relatives that are facing a life limiting illness [1] . Globally, emergency centers (ECs) are facing an increasing population of patients requiring pallia- tive and end of life care [2] . With an increasing world population and increasing life expectancy, the WHO has recognized the lack of PC re- sources, particularly in developing countries [3] .According to the WHO, 78% of patients requiring PC live in low- and middle income countries and that globally only 14% of patients that require PC receive it [1] . In South Africa, rising rates of non-communicable diseases such as hyper- tension, diabetes, malignancies and infectious diseases like human im- munodeficiency virus (HIV) and Tuberculosis (TB) [4] are contributing
∗ Corresponding author. E-mail address: Chrisstraeuli@yahoo.com (C. Straeuli) .
to the amount of patients that require

Christopher Straeuli,Louis Jenkins, Nardus Droomer

www.elsevier.com/locate/afjem

elsevier

22 August 2022

peri irawan

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