Oncologic patients with tumor or therapy associated complications often seek out the ED as first contact point. Next to the rare classic oncologic emergencies, other causes are supposed to be more frequent. However, little is known about other reasons of patients with cancer to consult the ED.
The study is a retrospective data analysis of emergency visits of patients with active cancer or adjuvant therapy, who were taken by ambulance to the ED. From 1.1.2017–31.7.2017 data from all patient contacts were collected. The medical history of adult patients were searched for diagnosis of active malignant disease or adjuvant therapy, to be eligible for this study.
From a total of 1029 patient contacts 743 met the inclusion criteria. 425 male contacts (57%) and 318 female contacts (43%) were recorded. The median age was 67 years. The vast majority of patients (648, 87%) were in a palliative setting. 339 patients (46%) were under active treatment and 111 patient contacts (15%) were treatment associated. 384 patient contacts (52%) were tumor related. The most common malignancies were lung cancer (141, 19%), pancreatobilliary cancer (73, 10%), colorectal cancer (67, 9%) and breast cancer (54, 7%). The most frequently reasons for ED consultations were detorriation of general condition (140, 19%), pain (130, 18%), dyspnea (106, 14%) and fever (97, 13%). The most common diagnosis were infections (142, 19%) with pneumonia as the leading cause (61, 8%). Followed by pain (130, 18%), with cancer pain beeing the most common complication (52, 7%) and tumor progression (103, 14%). Data regarding OS until the date of censorship (28.2.18), 3 month mortality (3MM) and factors possibly influencing 3MM are yet immature, but will be added at time of presentation.
The majority of cancer patients seeking help at the ED are in a palliative setting. Cancer associated complications pose the most frequent cause for ED consultation. Lung cancer, pancreatobiliary and colorectal cancer present the most common malignancies related to ED visits. The results of the study may help to optimize the supportive treatment of cancer patients and may help to inform both oncological patients and primary care units about frequent complications associated with the diagnosis of cancer.
Clinical trial identification
Legal entity responsible for the study
Medical University of Vienna.
Has not received any funding.
All authors have declared no conflicts of interest.