# In-Hospital Death of Patients with Known Life-Threatening Disease: A Retrospective Analysis

## TL;DR

The study examines in-hospital deaths of patients with life-threatening diseases in a Dutch hospital, finding that advance care planning was rarely documented.

## Contribution

The study provides insights into the frequency of in-hospital deaths and the lack of documented advance care planning in patients with life-threatening diseases.

## Key findings

- 216 and 180 patients died in 2019 and 2022, respectively, with most referred from home.
- Advance care was documented in only 1% and 2% of cases in 2019 and 2022.
- Many in-hospital deaths could be considered expected, suggesting potential for improved advance care planning.

## Abstract

In the Netherlands, overtreatment at the end of life and the high incidence of in-hospital death have led to discussions on how to improve advance care planning.

To investigate in-hospital deaths at the Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands in 2019 and 2022 of patients previously diagnosed with at least one life-threatening disease, who received symptom-oriented treatment within seven days of admission.

Retrospective study.

Characteristics of the patient population and their final hospital admission were analyzed.

In the Canisius-Wilhelmina Hospital, 216 and 180 patients died in 2019 and 2022, respectively, who were treated for at least one life-threatening disease and who received symptom-oriented treatment within seven days of admission. Most of these patients were referred to the emergency room from home. They were admitted for median three days before their in-hospital death. Advance care was documented in 1% and 2% of cases in 2019 and 2022, respectively.

A significant number of in-hospital deaths at the Canisius-Wilhelmina Hospital in 2019 and 2022 could be considered expected deaths. Furthermore, advance care planning was rarely documented in these cases. Whether improvement of advance care planning could reduce the number of deaths occurring in-hospital should be the subject of further investigation.