Emergency department (ED) visits among cancer patients (pts) exceed those of the general population; acute oncology teams can influence strategy determining a reduction in ED accesses and hospitalizations. Local services may reflect number and type of admissions often referred to ED. Onco-Hemato Emergency Room (OHER) in Modena Hospital is a service completely dedicated to cancer pts needs integrated with Oncology Department since 2001.Medical team is composed by oncologists and hematologists, from Monday to Friday (08, 00-18, 00), Saturday (08, 00-12, 00). Otherwise pts must refer to ED. We tried to describe pts admitted to OHER between January, 1, 2007 and December, 31, 2017 by cancer types, reasons for visits and percentage of hospitalizations from OHER and ED with financial implications.
OHER data were obtained through the query of a relational database used to collect medical records, concerning all disease history including hospitalizations and planned evaluations. Pts were received regardless disease stage from suspected tumor to palliative care setting. ED term searches were conducted using a dedicated database.
28.680 admissions to OHER, of 11.239 pts, 5326 (47%) had a single access, the most recurrent one had 51 visits, 165 (0.6%) died there. According to the site of primary malignancy: digestive tract 24%, lung 16.5%, lymphoma 9%, acute and chronic leukemia 10%, breast 7.2%, colon-rectal 8.4%, urological 8%, myeloma 5%, head neck 4%, melanoma 1.4%, sarcoma 1.7%, hematologic 2.3%, thrombotic purpura 0.2%,other 2.3%. Most common reasons determining visits were worsening of disease (14.6%), pain (12%), therapy toxicities (8.6%), suspected tumor (5.6%), deferrable (7%). January was the most crowded month (2900, 10%), December the less one (1952, 6.8%), Monday (6926) the most haunted day of the week. Hospitalizations in Oncology Department were 6.781 (23%), 1.710 (5.8%) in others. 10.246 cancer pts acceded to ED in the same period (1.4% of all pts); 5961(58%) were hospitalized. Average long of stay was 10 days.
Acute oncology can play a key role in management of emergencies; despite true level of saving is difficult to quantify accurately, OHER lead to save 81430 bed days with hypothetic financial saving.
Clinical trial identification
Legal entity responsible for the study
Medicina Oncologica Policlinico Modena.
Has not received any funding.
All authors have declared no conflicts of interest.