Cancer patients admitted in the emergency department: A single‐centre observational study

Santis, Rafael Barbosa de; Wainstein, Alberto Julius Alves; Machado, Gustavo Carvalho Oliveira Gonçalves; Santos, F; Melo, Mariana Ramos Peixoto; Drummond-Lage, Ana Paula

doi:10.1111/ecc.13758

Cited by 2 publications

(2 citation statements)

References 42 publications

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“…In Brazil, previous studies have shown that pain is the leading complaint during emergency admission among patients with cancer. 28-30 This aligns with our findings that pain and dyspnea were frequent symptoms reported at ED admission. However, few studies have explored the symptoms according to different tumor groups.…”

Section: Discussionsupporting

confidence: 89%

“…8,23 In Brazil, few studies have explored hospitalization outcomes of individuals with cancer. These studies have focused on different populations, such as those associated with ED visits [28][29][30] or ICU admissions 37 or have used population registry data sources, 38 posing challenges in making direct comparisons. Several studies reported poor outcomes associated with hospital readmissions among patients with cancer.…”

Section: Discussionmentioning

confidence: 99%

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Unplanned Hospital Admissions in Patients With Solid Tumors in Brazil: Causes and Progressive Disease's Impact on Outcomes

Hidalgo Filho,

Lazar Neto,

Sobottka

et al. 2024

JCO Glob Oncol

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PURPOSE Most patients with cancer will be hospitalized throughout the disease course. However, most evidence on the causes and outcomes of these hospitalizations comes from administrative data or small retrospective studies from high-income countries. METHODS This study is a retrospective cohort of patients with solid tumors hospitalized from February 1, 2021, to December 31, 2021, in a tertiary cancer center in São Paulo, Brazil. We collected data on cancer diagnosis, symptoms at admission, hospitalization diagnosis, and survival clinical outcomes during in-hospital stay (in-hospital mortality) and after discharge (readmission rates and overall survival [OS]). Progressive disease (PD) diagnosis during admission was retrieved from manual chart review if explicitly stated by the attending physician. We modeled in-hospital mortality and postdischarge OS with logistic regression and Cox proportional hazards models, respectively. RESULTS A total of 3,726 unique unplanned admissions were identified. The most common symptoms at admission were pain (40.6%), nausea (16.8%), and dyspnea (16.1%). PD (34.0%), infection (31.1%), and cancer pain (13.4%) were the most frequent reasons for admission. The in-hospital mortality rate was 18.9%. Patients with PD had a high in-hospital mortality rate across all tumor groups and higher odds of in-hospital death (odds ratio, 3.5 [95% CI, 3.0 to 4.2]). The 7-, 30-, and 90-day readmission rates were 11.9%, 33.5%, and 54%, respectively. The postdischarge median OS (mOS) was 12.6 months (95% CI, 11.6 to 13.7). Poorer postdischarge survival was observed among patients with PD (mOS, 5 months v 18 months; P < .001; hazard ratio, 2.4 [95% CI, 2.1 to 2.6]). CONCLUSION PD is a common diagnosis during unplanned hospitalizations and is associated with higher in-hospital mortality rates and poorer OS after discharge. Oncologists should be aware of the prognostic implications of PD during admission and align goals of care with their patients.

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Section: Discussionsupporting

confidence: 89%