Unexpected death on an acute palliative care unit

Although most deaths in patients with advanced cancer are expected, no data are available on unexpected death (UD). This event can be really stressful for physicians who are unable to anticipate, prevent, or discuss UD, and for relatives who are not ready for such an acute emotional burden, despite previous good communication about the short-term prognosis. There is the need for more information, particularly in the setting of an acute palliative care unit where most patients are discharged to follow different therapeutic pathways, including continuing oncologic treatment, home care, or hospice.1,2 The aim of this prospective study was to assess the characteristics of patients who died unexpectedly in an acute palliative care unit.This report highlights that some patients may escape the final pathway commonly reserved to end-of-life care and communication, as well as all the measures used to assure a good death. A larger sample of patients could provide more consistent data, and our data should be considered preliminary. Further studies should be performed with larger numbers of patients and in different settings to provide further information on ED.