Background
Palliative care (PC) is key in managing chronic lung disease. Delivering patient-centred End-of-Life (EoL) care in hospital settings can be defying. Recent studies have shown high prescription rates of nonessential medication (NeM) and complementary diagnostic tests (CDT) in EoL inpatients.

Our aim was to review the management and interventions carried out in inpatients? last 48 hours of life.

Methods
An observational retrospective study of patients with a ?do-not-resuscitate? order who died in a secondary centre?s pulmonology ward during 2022 was conducted. Clinical records were revised and a descriptive analysis of patient data, prescriptions and medical devices used was made.

Results
A total of 37 patients died during this period, mostly men (76%), with mean age of 68±12 years. Stages III-IV lung cancer (65%) and COPD (14%) were the most frequent diagnoses. The median length of stay was 14 days (IQR 21).
Regarding last 48 hours of life, EoL was recognised in 65% of cases. Most patients (59%) had at least one CDT prescribed and 26 were submitted to disproportionate procedures. Only six patients had no futile medical devices placed at time of death. All patients had symptom-control medication and 89,2% had opioids prescribed; however, 89,2% of patients were prescribed NeM, including inhaled therapy (51%), antibiotics (38%) anticoagulants (46%) and cancer-target treatments (5%).

Conclusions
Although patients? EoL symptoms and needs were overall addressed, with an opioid prescription
rate well above those reported in our country, there?s still a significant need for education in EoL ethics. Early referral to PC teams is essential to provide best care and an opportunity to learn EoL best practice.