Attributes of cancer patients admitted to the emergency department in one year

doi:10.5847/wjem.j.issn.1920-8642.2014.02.001

Abstract

Abstract:

BACKGROUND: Cancer patients frequently visit the emergency department (ED) with various symptoms of cancer. The purpose of this study was to determine the clinical characteristics and 1-year survival rate of cancer patients in the ED of a university hospital.
METHODS: We conducted a retrospective review of 408 cancer patients who visited the ED between January 2011 and December 2011. Patient information on demographics, chief complaints, findings, and survival was gathered from the hospital registry and corresponding health administration.
RESULTS: The study included 240 (58.8%) males and 168 (41.2%) females with a median age of 57.9 years (range 19-87). Regarding cancer staging, 266 patients (65.3%) had metastatic disease and 142 (34.7%) had local and loco-regional disease. The hospitalization rate was 59.6%. The most common symptoms were shortness of breath (23.2%), pain (17.8%), fever (14.2%), and nausea/vomiting (14.4%). The most common cancer sites were the lung (32.5%), gastrointestinal system (25.4%), and breast (9.3%). The initial evaluation determined progressive disease (42.4%), chemotherapy effects (20.7%), infections (17.2%), radiotherapy effects (4.7%), extravasation (1.8%), anemia (1.4%), and unknown (11.3%). During follow up, 191 (46.8%) patients died after admission to the ED. The 1-year overall survival of all patients was 7.3 months.
CONCLUSIONS: Symptom management in cancer patients is a complex multifaceted concern for the emergency physician. Because of the increasing prevalence of cancer patients, emergency physicians should develop consensus algorithms in collaboration with the relevant disciplines to manage the commonly encountered problems.

Key words: Cancer, Oncology, Emergency department, Survival

Muallaoglu Sadik, Karagün Ozlem, Mertsoylu Huseyin, Besen AliAyberk, Sezer Ahmet, Ozyilkan Ozgur. Attributes of cancer patients admitted to the emergency department in one year[J]. World Journal of Emergency Medicine, 2014, 5(2): 85-90.

Figures/Tables 6

Figure 1.

Table 1

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Table 3

Figure 2.

Figure 3.

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Characteristics	Results
Age (yr, mean±SD)	57.9±13.3 (19-87)
Gender (n, %)
Male	240 (58.8)
Female	168 (41.2)
Cancer stage (n, %)
Stage I	2 (0.5)
Stage II	15 (3.5)
Stage III	125 (30.7)
Stage IV	266 (65.3)
Number of emergency admissions (n, %)
1	222 (54.5)
>=2	186 (45.5)
Result of ED visits (n, %)
Hospitalization	243 (59.6)
Discharge from the ED	165 (40.4)
Final diagnosis (n, %)
Progressive disease	172 (42.4)
Chemotherapy effects	84 (20.7)
Infections	70 (17.2)
Radiotherapy effects	19 (4.7)
Others	59 (14.5)
Mortality (n, %)
Death during follow-up	191 (46.8)
Alive at end of follow-up	217 (53.2)

Site	n (%)
Lung	133 (32.5)
Breast	38 (9.3)
Gastrointestinal
Colon	24 (5.8)
Rectum	17 (4.1)
Gastric	22 (5.3)
Esophagus	7 (1.6)
Cholangiocellular	9 (2.2)
Pancreas	16 (3.9)
Ampulla water	2 (0.4)
Gallbladder	3 (0.7)
Hepatocellular	4 (0.9)
Gynecological
Ovarian	12 (2.9)
Cervix	15 (3.6)
Uterine	5 (1.2)
Genitourinary
Bladder	8 (1.9)
Prostate	12 (2.9)
Renal	5 (1.2)
Testicular	2 (0.4)
Lymphoma	30 (7.3)
Head and neck
Larynx	7 (1.7)
Nasopharynx	8 (1.9)
Tongue	4 (0.9)
Soft tissue and mesothelioma	10 (2.4)
Brain	7 (1.7)
Neuroendocrine	5 (1.2)
Skin	2 (0.4)
Primary unknown	1 (0.2)

Symptoms and signs	n (%)
Shortness of breath	95 (23.2)
Pain	73 (17.8)
Fever	58 (14.2)
Nausea/Vomiting	59 (14.4)
Confusion	24 (5.8)
Weakness	19 (4.6)
Epilepsy/Hemiplegia	19 (4.6)
Diarrhea/Constipation	17 (4.1)
Icterus	13 (3.1)
Acid	7 (1.7)
Hematochezia	4 (0.9)
Vaginal bleeding	3 (0.7)
Melena	1 (0.2)
Dysphagia	1 (0.2)
Hemoptysis	1 (0.2)
Stomatitis	1 (0.2)

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