Chief complaints of patients with cancer who visit the emergency department over their oncologist’s outpatient clinic in South Korea

Abstract

Background There have been several reports of patients with cancer visiting the Emergency Department (ED) rather than the outpatient department of their oncologist. In this study, we aimed to analyze the chief complaints, visit time, and time spent in the ED between study groups of patients with cancer visiting the ED. This finding will help medical staff provide better care for patients with cancer and reduce time spent in the ED. Methods A total of 787 patients with cancer visited the Regional Emergency Medical Center between January 1, 2020, and December 31, 2020. After the exclusion criterion such as patients who were transferred to the ED with a referral issued slip, patients who were pregnant women or minors under the age of 18 were applied, data from 607 patients with cancer were collected retrospectively from electronic medical records at the hospital. The participating patients with cancer were divided into two groups: 1) ED group—those who were cared for by the ED physician and 2) Referral group—those who were referred to their oncologist for hospitalization. Results We found that 40% of the total patients with cancer included in the study visited the ED with a chief complaint of pain. It was observed that the highest frequency of visits to the ED was around noon during clinic hours. The length of ED stay was 169 and 566 min for the ED and referral groups, respectively. Conclusion It would be more beneficial for patients with cancer visiting the ED to be quickly discharged from the ED physician’s active care for their symptoms. This usage of ED services will reduce unnecessary waiting time.

Drivers of Emergency Department Use Among Oncology Patients in the Era of Novel Cancer Therapeutics: A Systematic Review

“…Patient presentations at the ED showed specific trends; pain (up to 66%), gastrointestinal (GI) complications (2.7-62%), dyspnea (3.6-16.9%), infection/fever, and nausea/vomiting were common. 11 , 14 , 29-31 , 35 , 37 , 39 , 41 , 43-45 , 50 , 59 , 62 , 65 , 68 , 70 Compared to all other diagnoses combined, pain was higher in patients with prostate cancer (19.7%). 11 Compared to all age groups combined, pain and GI complaints were higher among patients aged 18-44 and 45-64.…”

“…Thirty-three studies evaluated patient-level factors and 8 factors were significant ( Table 3 ). 7 , 11 , 14 , 29-33 , 35-37 , 41 , 44-47 , 49-59 , 61 , 62 , 64-66 , 68 Up to 53.6% of patients with cancer who visit the ED were aged 65-74 years and up to 89% of patients were married. 11 , 29 , 35 , 41 , 49 , 60 Employed patients constituted 55.6% of ED users, and 45.3% of patients reported sufficient income.…”

“…Nineteen studies included ED visit characteristics. 7 , 14 , 29 , 30 , 32 , 33 , 35 , 41 , 47 , 52 , 56 , 59-62 , 64-66 , 68 Most visits occur during working hours, with up to 86.4% of arrivals during the week, up to 66% before midnight, and up to 71.1% between 7:00 AM and 6:59 PM. 7 , 29 , 41 , 59 , 62 , 69 Most patients present with a severity index of “potentially unstable” (40.0-50.0%) or “stable-urgent” (up to 51.4%).…”

“… 7 , 29 , 41 , 59 , 62 , 69 Most patients present with a severity index of “potentially unstable” (40.0-50.0%) or “stable-urgent” (up to 51.4%). 29 , 33 , 68 …”

Diagnosis of cancer in the Emergency Department: A scoping review

“…Indeed, studies that have analyzed ED visits of oncologic patients vary depending on the geographical location of the study. Although the reasons for visiting are often the same (pain, nausea‐vomiting, or fever), the types of cancer, the anti‐cancer therapies used, and the percentage of home discharge vary greatly in Africa, 59 Asia, 60 , 61 Europe, 62 , 63 and America. 64 , 65 Indeed, the epidemiology of cancers varies substantially vary across countries depending on the degree of economic development and associated social and lifestyle factors.…”