Evaluation of the frequency of patients with cancer presenting to an emergency department

Abstract

SUMMARY OBJECTIVE: This study aims to determine the demographic characteristics of cancer patients admitted to an emergency department and determine the relationship between the frequency of admission to the emergency department and oncological emergencies and their effect on mortality. METHODS: This observational, prospective, diagnostic accuracy study was performed in the ED of a tertiary care hospital. Patients over the age of 18 who were previously diagnosed with cancer and admitted to the emergency service for medical reasons were included in the study. We recorded baseline characteristics including age, gender, complaints, oncological diagnosis, metastasis status, cancer treatments received, the number of ED admissions, structural and metabolic oncological emergency diagnoses in the ED, discharge status, length of hospital stay, and mortality status. RESULTS: In our study, 1205 applications related to the oncological diagnosis of 261 patients were examined. 55.6% of the patients were male, and 44.4% were female. The most common metabolic oncological emergency was anemia (19.5%), and the most common structural oncological emergency was bone metastasis-fracture (4.6%.) The mean score of admission of patients to the emergency department was four times (min: 1 max: 29) during the study period. A total of 49.4% (n: 129) of the patients included in the study died during follow-up, and the median time of death was 13 days after the last ED admission. CONCLUSION: The palliation of patient symptoms in infusion centers that will be established in the palliative care center will contribute to the decrease in the frequency of use of emergency services.

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

“…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%).…”

“…The average number of visits to the ED per patient was 3-4 visits in 2 studies. 38 , 52 10% of patients had visited the day prior, up to 26.6% already presented within 30 days, 25% had an ED visit or admission within a week, 25.5% had admissions within 30 days, and 58.3% had a visit within the last year. 29 , 33 , 49 , 62 31.2% had 2+ ED visits, and nearly 30% visited the ED 5+ times.…”

“… 29 This is similar across the literature (range of admission = 5.3%-72.1%). 7 , 11 , 34 , 37 , 41 , 52 , 63 , 64 Patients with breast cancer were more likely discharged following their visit (AOR: 2.176, 95% CI: 1.387-3.416, P < . 01) and older patients were more likely admitted (OR: 1.014, 95% CI: 1.004-1.024, P < .…”

Prognostic Importance of Lactate and Blood Gas Parameters in Predicting Mortality in Patients with Critical Malignancies

“…‘Critically ill’ is a broad term used for patients who need rapid medical treatment and who have higher mortality and morbidity ( 3 , 5 ). These patients should be monitored carefully ( 4 ).…”

“…These patients are admitted to the red triage zone of the emergency medicine clinic. Numerous classifications have been developed to identify these patients ( 5 ).…”