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Repeated radiological procedures in the last 6 months of life in old age: a retrospective study
  1. Joseph Hawkins1,
  2. Sam Beardsmore-Rust2,
  3. Myra Adra2 and
  4. Zoe Halford3
  1. 1 Palliative Care, ASPH, Chertsey, Surrey, UK
  2. 2 Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, Surrey, UK
  3. 3 Martlets Hospice, Hove, UK
  1. Correspondence to Dr Joseph Hawkins; joseph.hawkins{at}nhs.net

Abstract

Objectives This novel study looks at the use of radiological procedures in an elderly cohort of patients in their last 6 months of life. Radiological imaging plays a central part of clinical investigations, but too many may override the judgement of benefits, risks and resources. There is little information on the burden of radiological procedures performed towards the end of life in patients of old age.

Methods Data from every fourth patient aged 80 years and over who died between 4 July 2021 and 30 December 2021 in a National Health Service (NHS) hospital were collected. All radiological procedures performed within the last 6 months of the patients’ life were recorded from clinical documentation and related to their age.

Results 96 patients were studied with a total of 699 radiological procedures performed. When scaled up, costs of CT and MRI scans alone are conservatively estimated as £312 000/annum in patients aged ≥80 years in their last 6 months of life for a single medium-sized NHS hospital.

Conclusions A very large number of radiological procedures were performed towards the end of life among patients of old age. This is consistent with the national trend of increased medicalisation and poor recognition of dying.

  • Advance Care Planning
  • Hospital care
  • Palliative Care

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Footnotes

  • Contributors JH and SB-R contributed to study design and planning. SB-R and MA contributed to data collection. JH, SB-R and MA contributed to data analysis. JH, SB-R and ZH contributed to the interpretation of data, writing and review of the manuscript. JH is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.