4027 - Unplanned emergency department use by people receiving ambulatory anti-cancer agents with potential febrile neutropenia

Background

Recent advances in cancer therapies have resulted in a greater number of people receiving chemotherapy in ambulatory care settings worldwide. In Spain emergency departments, is the single point of entry to acute inpatient services, and therefore play a pivotal role in the immediate management of chemotherapy complications. This study set out to explore ED use by ambulatory patients receiving anti-cancer agents in febrile neutropenia episodes. Data will contribute to service innovation for optimal patient care and health service efficiency.

Methods

A 12 month retrospective observational study of unplanned ED presentation by patients within 30 days of receiving anti-cancer therapy for a range of cancer diagnoses.

Results

The preliminary main results are the following. There were 382 ED presentations of chemotherapy related FN in cancer patients and a sample of 170 were selected in regards to a 30-day frame between the FN episode and the chemotherapy administration. The most common diagnoses were breast (33/170; 19.4%); bowel (32/170; 18.8%) and genitourinary cancers (30/170; 17.6%). A total of 145 (145/170; 85.2%) were given a triage level III and the rest (25/170; 14.7%) a triage level II.

Conclusions

There is still some important data to exploit such as median time from triage to medical attention and median time from triage to antibiotic, which will allow the researchers to establish the percentage of compliance with evidence based guidelines. As reported in international literature the compliance is challenging in a busy and unpredictable ED setting. Therefore it will be interesting to measure our compliance rates and explore opportunities to further improve adherence to evidence-based guidelines and aim for better clinical outcomes in case our results correlate with current literature.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Ethic Committee Hospital Clinic Barcelona.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.