Introduction: Cancer is a pervasive global problem with significant healthcare utilisation and cost.
Emergency departments (EDs) see large numbers of patients with oncologic emergencies and act as
“gate-keepers” to subsequent hospital admissions. A proportion of such hospital admissions are rapidly
discharged within 2 days and may be potentially avoidable.
Methods: Over a 6-month period, we conducted a retrospective audit of active cancer patients
presenting to the ED with subsequent admission to the Department of Medical Oncology. Our aims
were to identify independent factors associated with a length of stay ≤2 days; and characterise the
clinical and resource needs of these short admissions.
Results: Among all medical oncology admissions, 24.4% were discharged within 2 days. Compared
to longer stayers, patients with short admissions were significantly younger (P=0.010), had lower
National Early Warning Scores (NEWS) (P=0.006), and had a lower proportion of gastrointestinal
and hepatobiliary cancers (P=0.005). Among short admissions, common presenting medical problems
were infections (n=144, 36.3%), pain (n=116, 29.2%), gastrointestinal complaints (n=85, 21.4%) and
respiratory complaints (n=76, 19.1%). These admissions required investigations and treatments already
available at the ED.
Conclusion: Short admissions have low resource needs and may be managed in the ED. This may help
save valuable inpatient bed-days and reduce overall healthcare costs.
Keywords: Emergency medicine, healthcare use, oncology, palliative care, unplanned cancer admission