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Background <p>Severely frail patients who develop acute terminal illness are frequently admitted to the emergency department (ED) for initiation of acute basic end-of-life care. Such admissions are often inappropriate for patients and economically burdensome. ED-based mobile emergency units have been suggested as safe and cost-effective options for assessing and treating patients at home instead of admitting them.</p> Objectives <p>To describe the management of patients with acute end-of-life needs using a newly started mobile emergency unit (MEU).</p> Method <p>In this retrospective observational study, we analyzed patients treated at their residence with acute end-of-life care initiated by a MEU between 1st of September 2023 and 31st of December 2024 in the referral area of the Esbjerg University Hospital. Data were extracted from the patients’ electronic hospital records and included patient demographics, frailty, comorbidities, reason for referral, diagnostics and treatments provided, prior end-of-life care documentation, place of care, number of MEU visits, and short-term mortality. The diagnosis was based on ICD-10-DK.</p> Results <p>The MEU was dispatched 2,247 times during the study period and assessed 126 patients as requiring acute end-of-life care. These patients were 82 ± 10.7 years old, 67% lived at a nursing home, 44% had a dementia diagnosis and their clinical frailty scale was on average 7.4 ± 1.0. The most frequent diagnoses leading to end-of-life care were infection (46%), loss of consciousness (41%) and nonspecific symptoms (19%). The MEU enabled 98% of acute terminally ill patients to remain at their residence during their final days. The patients died within a median of 3 days and the 7-day mortality was 67%. Patients were visited 1.8 ± 1.1 times at home by the MEU during that period.</p> Conclusion <p>The integration of the MEU enabled acute end-of-life care at the patients´ residence in most cases. Patients receiving end-of-life care by the MEU were typically severely frail nursing home residents. Further studies are warranted to examine whether this service, compared to admission-based care, leads to higher patient and relative satisfaction, and lower healthcare expenses.</p>

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Acute end-of-life care delivered by a physician-led mobile emergency unit at the patients´ residence: a retrospective observational study

  • 期刊论文

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  • 发表日期：

    2026年7月31日

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  • Johanne Overgaard Wessels,
  • Masoud Moradi,
  • Kristin Valdis Örnolfsdóttir,
  • Anne Lund Krarup,
  • Dorte Melgaard,
  • Lise Mondrup,
  • Line Emilie Lilholm Laugesen,
  • Mette Rahbek Kristensen,
  • Peter Biesenbach

摘要

Background

Severely frail patients who develop acute terminal illness are frequently admitted to the emergency department (ED) for initiation of acute basic end-of-life care. Such admissions are often inappropriate for patients and economically burdensome. ED-based mobile emergency units have been suggested as safe and cost-effective options for assessing and treating patients at home instead of admitting them.

Objectives

To describe the management of patients with acute end-of-life needs using a newly started mobile emergency unit (MEU).

Method

In this retrospective observational study, we analyzed patients treated at their residence with acute end-of-life care initiated by a MEU between 1st of September 2023 and 31st of December 2024 in the referral area of the Esbjerg University Hospital. Data were extracted from the patients’ electronic hospital records and included patient demographics, frailty, comorbidities, reason for referral, diagnostics and treatments provided, prior end-of-life care documentation, place of care, number of MEU visits, and short-term mortality. The diagnosis was based on ICD-10-DK.

Results

The MEU was dispatched 2,247 times during the study period and assessed 126 patients as requiring acute end-of-life care. These patients were 82 ± 10.7 years old, 67% lived at a nursing home, 44% had a dementia diagnosis and their clinical frailty scale was on average 7.4 ± 1.0. The most frequent diagnoses leading to end-of-life care were infection (46%), loss of consciousness (41%) and nonspecific symptoms (19%). The MEU enabled 98% of acute terminally ill patients to remain at their residence during their final days. The patients died within a median of 3 days and the 7-day mortality was 67%. Patients were visited 1.8 ± 1.1 times at home by the MEU during that period.

Conclusion

The integration of the MEU enabled acute end-of-life care at the patients´ residence in most cases. Patients receiving end-of-life care by the MEU were typically severely frail nursing home residents. Further studies are warranted to examine whether this service, compared to admission-based care, leads to higher patient and relative satisfaction, and lower healthcare expenses.