CN101 - Continuous care unit for patients with cancer: Identification of the user profile and follow-up needs

Background

Higher rates of active therapy, increasing complexity and new treatment modalities, directly impact the incidence of acute decompensations in cancer patients, forcing them to attend Emergency Departments. Optimizing urgent care through effective triage, timely symptom recognition and initiation of recommended clinical algorithms is essential to improve the quality of cancer care. We aim to present our experience during the first four months of running a part-time Continuous Care Unit (CCU) for cancer patients.

Methods

Data from patients who required attention in the CCU were prospectively collected during the period: 13/11/2023 - 15/03/2024. The CCU is composed by an internist and a nurse who handle emergencies in a 4-bed unit. Patients are accepted from 9am to 5pm, and outside of these hours, they must follow the usual care pathway. A descriptive analysis of the variables has been conducted.

Results

The CCU received 633 evaluation requests, of which 551 (87%) were accepted. The main reason for non-acceptance was lack of space in the unit (76.8%). 300 patients were oncological (54.4%) and 251 were haematological (45.5%), with a mean age of 63.6 years (SD 13.4). Triage defined an urgency level 3 in 243 patients (44.1%) and level 4 in 204 patients (37%). The main underlying diagnoses were digestive tumours (13.8%), lymphoproliferative syndromes (13.4%), and breast cancer (10.2%). Principal reasons for consultation were fever (22.7%), gastrointestinal symptoms (12.5%), respiratory symptoms (11.8%), analytic alterations (8.5%) and thoracentesis/paracentesis (6.9%). 83 patients (15.1%) required admission, among whom 14 (16.9%) were hospitalized on a domiciliary basis. Of the 469 patients discharged home, 374 (80%) could be followed up by their reference teams, while 88 (18.8%) required re-evaluation at the CCU within 24-48 hours.

Conclusions

A CCU offers specialized diagnosis and treatment of urgent care conditions in cancer patients. The results show a low admission rate. However, 18.8% of the patients discharged required clinical follow-up within 24-48h, demonstrating the need to optimise continuous care pathways to address this need.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

I. Casablancas.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.