Reasons for Emergency Department Visit, Outcomes, and Associated Factors of Oncologic Patients at Emergency Department of Jimma University Medical Centre

Abstract

Introduction The number of oncologic patients visiting the emergency department (ED) is increasing and represent a challenge for the emergency team owing to they might have acute sign and symptoms of a still undiagnosed malignancy, management of treatment-related side effects, co-morbidities, and palliative care. Thus, this study was aimed to identify reasons for ED visits, management outcomes, and associated factors of oncologic patients. Patients and Methods A prospective cross-sectional study was conducted from March 11, 2021 to August 25, 2021 at the ED of Jimma University Medical Center on a total of 338 oncologic patients. Data were collected from the patient and the patient’s medical record using a questionnaire developed from up-to-date similar literatures. The questionnaire was started filled out upon diagnosis of cancer and completed during discharge from the ED. The outcomes of the patients were dichotomized into died and survived then, it was analyzed using frequency and bivariate logistic regression. Results The most common reasons for oncologic patients ED visit were neutropenic fever 79 (23.4%) followed by vomiting 38 (11.2%) and electrolyte abnormality 37 (10.9%) respectively. Among oncologic patients visited ED, 137 (40.5%) of them were admitted to ward and 126 (37.3%) of them were discharged with improvement while 64 (18.9%) of them were died. Based on multivariate logistic regression, those patients who had distant metastasis cancer (AOR 1.85; 95% CI 1.03–7.21), comorbidity (AOR 2.56; 95% CI 1.20, 6.96), and ECOG >3 (AOR 2.40; 95% CI 1.25,13.43) were more likely to die than their counterparts. Conclusion Most of the oncologic patients visited ED due to neutropenic fever, nausea and or vomiting, and electrolyte disorder. Amongst oncologic patients who were visited ED, most of them were admitted to ward while around one-fifth of them were died. Having distant metastasis cancer, comorbidity and ECOG >3 were independent predictors of an oncologic patient’s outcome at the ED.

Risks of Early Mortality and Associated Factors at Adult Emergency Department of Jimma University Medical Center

“…Moreover, the JUMC conducts healthcare research and is the only teaching hospital found in the Southwest of Ethiopia. 14 The adult emergency department of JUMC has 66 beds and provides diagnostic testing and treatment for patients requiring emergency care. 15 …”

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.…”