PATTERNS AND CAUSES OF END-OF-LIFE HOSPITAL ADMISSIONS: NOVEL INSIGHTS FROM A TERTIARY CARE CENTER IN RIYADH, SAUDI ARABIA

Abstract

Background Hospital admissions at the end of life are a significant aspect of palliative care, often triggered by acute symptoms or gaps in care delivery. Understanding the patterns and causes of such admissions is essential for optimizing symptom management, minimizing unnecessary hospitalizations, and enhancing advance care planning. While studies from Canada, England, and Japan have highlighted common end-of-life admission triggers such as dyspnea, pain, and gastrointestinal symptoms, data from Saudi Arabia remain limited.   Methods This retrospective cohort study analyzed end-of-life hospital admissions at a tertiary care center in Riyadh, Saudi Arabia, from January 2022 to March 2024. The study included 586 patients aged over 16 years with advanced malignancies who expired during their hospital stay. Data were extracted from electronic medical records and analyzed using SPSS version 30.0. Variables included demographics, cancer diagnosis, admission reasons, and length of stay. Associations between cancer types and admission diagnoses were evaluated using Chi-Square tests.   Results The cohort included 586 patients (52.2% male), with a mean age of 66.82 ± 15.81 years. Most patients (81.5%) had stage IV cancer, with gastrointestinal malignancies being the most common (51.2%). The primary reasons for admission were deterioration of performance status (28.8%), gastrointestinal symptoms (21%), and respiratory causes (16.6%), including pneumonia (86.3%). Altered consciousness was noted in 13.3% of cases, and pain and sepsis were common among other causes. Length of stay averaged 21.64 ± 15 days, with 6.7% of patients dying within 48 hours of admission. Significant associations were observed between cancer types and specific admission diagnoses, such as malignant bowel obstruction in colorectal cancer (p < 0.01) and pneumonia in gastrointestinal malignancies (p < 0.01).   Discussion This study provides the first regional insights into end-of-life hospital admissions, emphasizing functional decline, gastrointestinal complications, and respiratory issues as predominant reasons. These findings align with international data and underscore the need for targeted interventions, including symptom-focused care, advance care planning, and telehealth integration to reduce hospitalizations. Future research should focus on evaluating community-based palliative care models and their impact on reducing distressing end-of-life admissions in Saudi Arabia. Conclusion

End-of-life hospital admissions in Riyadh reflect global patterns, driven by advanced cancer-related complications. Enhancing symptom management