The Cancer Emergency Department—The Ohio State University James Cancer Center Experience

Delatore, Luca

doi:10.1016/j.emc.2018.04.012

Cited by 7 publications

(9 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Research demonstrates that cancer-specific pathways in general within an ED triage system can improve outcomes in terms of inpatient admission, decreased ED visits, and decreased overall mortality. [27][28][29] Given the variable outcomes among different cancer subtypes our study underscores importance of considering cancer type in the risk stratification process of this uniquely vulnerable patient population.…”

Section: Discussionmentioning

confidence: 88%

Impact of underlying malignancy on emergency department utilization and outcomes

et al. 2021

View full text Add to dashboard Cite

Cancer patients frequently utilize the emergency department (ED) for a variety of diagnoses both related to and unrelated to their cancer, yet ED outcomes for cancer patients are not well documented. This study sought to define risks and identify predictors for inpatient admission and hospital mortality among cancer patients presenting to the ED. Patients and Methods:We utilized the National Emergency Department Sample to identify patients with and without a diagnosis of cancer presenting to the ED between January 2016 and December 2018. We used multivariable mixedeffects logistic regression models to assess the influence of cancer on outcomes of hospital admission after the ED visit and hospital mortality for the whole patient cohort and individual presenting diagnoses.Results: There were 340 million weighted ED visits, of which 8.3 million (2.3%) were associated with a cancer diagnosis. Compared to non-cancer patients, patients with cancer had an increased risk of inpatient admission (64.7% vs. 14.8%; p < 0.0001) and hospital mortality (4.6% vs. 0.5%; p < 0.0001). For each of the top 15 presenting diagnoses, cancer patients had increased risks of hospitalization (odds ratio [OR] range 2.0-13.2) or death (OR range 2.1-14.4). Although our dataset does not contain reliable estimation of stage, cancer site was the most robust individual predictor associated with the risk of hospitalization or death compared to other clinical or system-related factors.Conclusions: Cancer patients in the ED have high risks for hospital admission and death when compared to patients without cancer. Cancer patients represent a distinct population and may benefit from cancer-specific risk stratification or focused interventions to improve outcomes.

show abstract

Section: Discussionmentioning

confidence: 88%

Impact of underlying malignancy on emergency department utilization and outcomes

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The increased acute care needs of patients with cancer and the increased specialization and complexity of cancer care are leading to an increased focus on acute oncology that requires a multifaceted approach to care provision [3,4]. New models of care to provide unscheduled care to patients with cancer are being developed with pilot studies demonstrating the potential benefit of multidisciplinary care for symptom management [3,[5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

A hybrid model of acute unscheduled cancer care provided by a hospital-based acute care clinic and the emergency department: a descriptive study

Bischof

Bush

Shams

et al. 2021

Support Care Cancer

View full text Add to dashboard Cite

Purpose Patients with cancer often experience medical events that require immediate evaluation. These evaluations typically occur in an emergency department (ED), but there is increasing interest in providing this care in other settings. We report on a novel care model whereby a nursing hotline is used to triage patients to the ED or to the North Carolina Cancer Hospital Infusion Center (NCCHIC). Methods A retrospective study of adult patients with a neoplasm diagnosis seeking acute care at a large academic hospital pre-and post-initiation of the novel care model in January of 2016. Patients were identified by querying the electronic medical record and clinic administrative data during matched 6 month pre-and post-periods. Results During the pre-initiation period, 1346 patients visited the ED on 1651 occasions (76.1% admission rate). In the post-initiation period, 1434 patients visited the ED on 1797 occasions (81.5% admission rate), and 246 patients visited the NCCHIC on 322 occasions (68.9% admission rate). The emergency severity index (ESI) in the pre-initiation ED group was primarily ESI 2 (30.6%) and ESI 3 (65.4%). In the post-initiation ED group, the ESI was similar (32.6% ESI 2 and 64.2% ESI 3). In contrast, the NCCHIC predominantly treated lower acuity patients (65.8% calculated ESI of 4/5). Conclusions This model demonstrates a multidisciplinary partnership to providing acute unscheduled care for patients with cancer. In the early implementation phase of this model, approximately 15% of patients, generally of lower acuity, were seen in the NCCHIC.

show abstract

“…The COVID‐19 pandemic has further exacerbated this issue, with reports of a drastic worldwide reduction in rates of cancer screening 58 . The creation of rapid cancer diagnostic centers may enhance testing and care access 50,56 …”

Section: Discussionmentioning

confidence: 99%

“…For example, select centers in the United States have established specialized cancer EDs or urgent care centers with expertise in the management of acute cancers and the complications of chronic cancer treatment such as chemotherapeutic toxicity. 50 , 51 , 52 , 53 Strengthening the link between oncology and emergency medicine teams with a multidisciplinary approach could improve the quality, efficiency, and continuity of care for these patients. 10 , 50 , 54 , 55 , 56 The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established with support from the National Cancer Institute to expand the knowledge around the treatment of oncologic emergencies in the emergency medicine setting by facilitating collaborations across oncology and emergency medicine.…”

Section: Discussionmentioning

confidence: 99%

“…It is also unclear if system or care enhancements could improve the care or outcomes of cancer patients identified in the ED. For example, select centers in the United States have established specialized cancer EDs or urgent care centers with expertise in the management of acute cancers and the complications of chronic cancer treatment such as chemotherapeutic toxicity 50–53 . Strengthening the link between oncology and emergency medicine teams with a multidisciplinary approach could improve the quality, efficiency, and continuity of care for these patients 10,50,54–56 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis of cancer in the Emergency Department: A scoping review

et al. 2023

View full text Add to dashboard Cite

Background The Emergency Department (ED) plays a key role in the identification and care of acute medical conditions, including cancer. In this scoping review, we aimed to determine the role of the ED in the acute diagnosis of cancer. Methods We conducted a scoping review of articles according to Preferred Reporting Items for Systematic Review and Meta‐Analyses (PRISMA) using PubMed and Google Scholar. We screened studies of adults with a new diagnosis of cancer in the ED. We included randomized control trials, prospective, retrospective, and cross‐sectional observational studies, and case reports published in English since 2000. We grouped the articles into categories based on their objectives and findings. Results Of the 4459 articles, we included 47 in the review. The identified studies fell into three major categories: (1) studies describing the incidental diagnosis of cancer in the ED (n = 11, 23%), (2) studies characterizing the acute initial presentation of cancer in the ED (n = 19, 41%), and (3) studies describing the ED as a pathway to cancer diagnosis in the healthcare system (n = 17, 36%). Across the studies, cancer diagnoses in the ED were more likely in patients with higher comorbidities, occurred at later stages, and resulted in worse survival rates. Conclusions The ED plays a prominent role in the initial diagnosis of cancer. Efforts must be made to integrate the ED within the cancer care continuum.

show abstract

The Cancer Emergency Department—The Ohio State University James Cancer Center Experience

Cited by 7 publications

References 6 publications

Impact of underlying malignancy on emergency department utilization and outcomes

Impact of underlying malignancy on emergency department utilization and outcomes

A hybrid model of acute unscheduled cancer care provided by a hospital-based acute care clinic and the emergency department: a descriptive study

Diagnosis of cancer in the Emergency Department: A scoping review

Contact Info

Product

Resources

About