Predicting deaths – estimating the proportion of deaths that are ‘unexpected’

Abstract

A key workstream within the National End of Life Care Strategy is the identification by health professionals of individuals who are in the last year of life so that they can be offered Advanced Care Planning. End of Life Care Registers are being developed to support this by holding information on these patients. This information will be readily available to health and social care professionals who may be involved in planned or emergency care for these individuals. There is conflicting information on the proportion of the population for whom this may be possible. There is also a desire to understand the extent to which death is predictable in order to plan care and to estimate costs specifically of end of life care. This paper summarises data from a number of sources to try to estimate the proportion of registered deaths which may be unexpected and therefore unlikely to be included on an End of Life Care Register. In some cases an unexpected death has been defined as “any death not due to terminal illness; or a death the family was not expecting” ii. However, patients with chronic or terminal diseases also die unexpectedly and this definition as will be seen in this report may be too stringent.