Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

Abstract

Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life .

Oncologic emergencies in a cancer center emergency department and in general emergency departments countywide and nationwide

“…Research on CP ED visits has focused primarily on cancer type and chief complaints [ 1 , 6 , 7 ] end-of-life ED visits [ 3 , 8 , 9 ] or specific cancer types [ 10 – 12 ]. Most of this research has focused on commonalities among CPs; to our knowledge, none has compared the characteristics of CPs and NCPs who visit the ED, either in cancer centers or general hospitals.…”

Evaluation of Managerial Needs for Palliative Care Centers: Perspectives of Medical Directors

“…(Turgay and Kav, 2012;Budkaew and Chumworathayi, 2013) The lack of training programs and a standardized education with guidelines inadequate staffing in hospitals have been mentioned as the problems to be solved for efficient palliative care in Turkey (Turgay and Kav, 2012) In Thailand, the need for formal education in palliative care and development of palliative care services for terminal cancer patients have been emphasized (Budkaew and Chumworathayi, 2013) . One of the main causes of terminally ill cancer patients' emergency visits were found as the lack of sufficient trained caregivers,it is claimed that an effective palliation of end-stage cancer patients causes to improve their quality of life (Yildirim and Tanriverdi, 2014). Similar studies were carried on in other countries and some interventions have been made and staff benefitted from the educational program on PC (Nagamatsu 2014) .…”

Characteristics of advanced cancer patients admitted to the palliative care unit from the emergency department

“…reported in their study that 60% of 107 Turkish cancer patients made at least one visit to ED within 1 month before death. [ 14 ] The most common site of the primary tumor was lung and symptom dyspnea as well. In our study, cancer patients with gastrointestinal tumors were admitted more frequently, and lung tumors were the second.…”