One in three patients in hospital likely to die within 12 months

by Cara Macdowall

Almost one in three patients in hospital at any given time is likely to die within 12 months.

A new study led by an academic from the University of Glasgow examined the , and of more than 10,000 patients in 25 hospitals across Scotland, identified on a single day.

The findings of the survey, the first of its kind in the world, showed that with 28.8% of patients likely to die within 12 months of a admission, more work needs to be done to recognise when patients are nearing the end of their lives and their potential need for palliative care.

Of the 10,743 patients, the majority (64.1%) were aged 65 years and over. 54.7% were women, 45.3% men.

The found that men are more likely to die than women for the majority of age groups. The mortality rate rose steeply with age and was three times higher at one year for patients aged 85 and over compared to those who were under 60.

Professor David Clark, Head of the School of Interdisciplinary Studies at the University of Glasgow said: "Until now there has been a dearth of information on the proportion of the hospital population at any one time that is in the last year of life and therefore on how hospital policies and services can be oriented to their needs. We were able to link hospital records to death registrations to get an exact figure. One striking result was that 9% of patients in hospital at any one time will die on that admission."

The study was carried out to address the growing challenge of an ageing population and the need for more services and plans to advise families as to what to do as patients near the end of their lives.

Published in Palliative Medicine, the study states that the role of hospitals in the delivery and planning of such care is of major significance, partly because so many people die there but also because provides an opportunity to identify those who may be approaching death.

The likelihood of dying in hospital varies across countries but is generally high. One recent study ranked Scotland 12th out of 36 countries for the proportion of all deaths occurring in hospital (59%). Japan came top at 78%.

Professor Clark said: "This study is the first of its kind to establish the proportion of hospital inpatients that die over a period of 12 months from a given date, and how the likelihood of death is related to gender and age.

"In order for appropriate plans to be made, there is a need for hospitals to be aware of the figures from this report and to adopt a more vigorous approach to identifying patients who are entering the last year of their lives.

"Our findings provide a platform to invest more energy in identifying on admission to hospital who are likely to die within a year - and then to develop appropriate care plans for them".

More information: David Clark, Matthew Armstrong, Ananda Allan, Fiona Graham, Andrew Carnon, and Christopher Isles, "Imminence of death among hospital inpatients: Prevalent cohort study." Palliat Med 0269216314526443, first published on March 17, 2014 DOI: 10.1177/0269216314526443

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