PP-58 ‘We can try to treat this and see what happens’: outcomes for patients admitted to hospital following specialist palliative medicine review in the emergency department

Introduction Bradford’s Marie Curie REACT service provides specialist palliative medicine in-reach into the Emergency Department to identify palliative patients and offer an alternative to an acute hospital admission where appropriate. 40% of patients seen by REACT in the Emergency Department are then admitted acutely. Aims This audit examines the reason for their admission and its outcome, with the Aim of informing discussions with patients regarding the outcomes of acute hospital admissions in this patient group. Methods Audit of records of 208 patients seen by REACT and admitted to hospital between June 2024 and May 2025. Results - 36% of patients died during their hospital admission following REACT review - 42% died after their admission, 23% were alive as of the date of analysis - Those with a cancer diagnosis and the 85+ age-group were more likely to survive to discharge - 39% of patients were admitted for treatment with the expectation of discharge –11% of these died during the admission - 19% of patients were admitted for a trial of treatment where the outcome was guarded – 52.5% died in hospital. 42.5% died after discharge, with 94% dying within 12 weeks. Only 5% of this sub-group were still alive at analysis. Conclusion Patients seen by REACT and admitted to hospital have a 1 in 3 chance of dying during admission. This rises to 1 in 2 for patients admitted for a trial of treatment; for those who improve with treatment over 90% die within 12 weeks. Impact This data quantifies what patients and their families can expect from an admission for trial of treatment. It informs honest and open discussions about prognosis to support patients to be cared for in their preferred location and to focus treatment on what matters most.