Alsuhebany Nada, Brown Jamie, Echave Jacquelyne, McBride Ali
College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.
J Adv Pract Oncol. 2022 May;13(4):367-378. doi: 10.6004/jadpro.2022.13.4.2. Epub 2022 Jun 21.
Cancer is the second leading cause of death in the United States. The incidence of emergency department (ED) visits by oncology patients has grown over the past years. Some ED visits are medically unnecessary and could be prevented with improved prevention measures.
To evaluate the incidence and causes of ED visits by cancer patients and evaluate outcomes and disposition of ED visits.
This single-center, retrospective chart review was conducted in a tertiary medical hospital. We collected data using an electronic medical record and included oncology patients with active cancer who had ED visits from January 1, 2018, to December 31, 2018. Key data collection included baseline demographics; type of malignancy; main chief complaint; clinic visit history; current and past ED visits; treatment and supportive care data; and disposition status if admitted. Pregnant patients, patients without active cancer, and patients who received outpatient care at clinics other than the University of Arizona Cancer Center were excluded.
This chart review study screened 1,659 encounters and included 205 encounters. Approximately 70% of the encounters were solid tumor patients and 30% were hematologic malignancies. Nearly 50% of the patients with hematologic malignancies had preventable ED visits while 32.8% of solid tumor patients had preventable ED visits. The most common preventable ED visit reasons in both groups were pain, fever, nausea, vomiting, and dehydration. Almost 50% of the patients in both groups were hospitalized with a median length of stay of 3 days. The majority of admitted patients were discharged home in both the solid tumor (82.3%) and hematologic malignancy (83.8%) groups.
This study showed that the rate of preventable visits was numerically higher in the hematologic cancer group compared with the solid tumor group. These findings highlight the potential need for implementing prevention measures in the future.
癌症是美国第二大死因。在过去几年中，肿瘤患者到急诊科就诊的发生率有所上升。一些急诊科就诊在医学上并无必要，通过改进预防措施是可以避免的。
评估癌症患者到急诊科就诊的发生率及原因，并评估急诊科就诊的结果和处置情况。
本研究为在一家三级医疗医院进行的单中心回顾性病历审查。我们使用电子病历收集数据，纳入了2018年1月1日至2018年12月31日期间到急诊科就诊的患有活动性癌症的肿瘤患者。关键数据收集包括基线人口统计学信息；恶性肿瘤类型；主要主诉；门诊就诊史；当前和既往急诊科就诊情况；治疗和支持性护理数据；以及入院时的处置状态。排除了孕妇、无活动性癌症的患者以及在亚利桑那大学癌症中心以外的诊所接受门诊治疗的患者。
本病历审查研究筛查了1659次就诊，纳入了205次就诊。约70%的就诊患者为实体瘤患者，30%为血液系统恶性肿瘤患者。血液系统恶性肿瘤患者中近50%的急诊科就诊是可预防的，而实体瘤患者中32.8%的急诊科就诊是可预防的。两组中最常见的可预防急诊科就诊原因是疼痛、发热、恶心、呕吐和脱水。两组中近50%的患者住院，中位住院时间为3天。实体瘤组（82.3%）和血液系统恶性肿瘤组（83.8%）中大多数入院患者出院回家。
本研究表明，血液系统癌症组可预防就诊率在数值上高于实体瘤组。这些发现凸显了未来实施预防措施的潜在必要性。
