Introduction to the special issue on acutely ill patients

Published:November 08, 2017DOI:
      As medicine becomes more successful the demand for acute care can only increase. Before modern intensive care many patients died during their first major medical emergency. Nowadays, even for octogenarians, death is an unusual outcome for any acute emergency admission. The inevitable consequence of this increased survival is that more patients have the opportunity to present again as acute emergencies. The received wisdom is that the rising demand for acute medical care is caused by these elderly returning patients with multiple co-morbid conditions. The situation, however, may not be that simple. In the first paper of this special edition on acute medicine reports that although in England medical admissions and deaths increased over the period 2012/13 to 2015/16, it was the admission of younger medical patients that increased more than those of older patients. The next paper points out that even though the vast majority of patients now survive an acute medical admission, their risk of dying subsequently is high. The relative risk increase is highest for the young, but the absolute increase in risk is greatest for the elderly. Therefore, physicians should not forget that for many patients their first admission to hospital for an acute illness is the beginning of the end of their life.
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