Recognition and evaluation of oncology-related symptoms in the emergency department.

STUDY OBJECTIVE

To identify the oncology patient population presenting to the emergency department and examine the causes and clinical management of oncology symptoms in the ED.

DESIGN

Retrospective review of 5,640 adult patients, with the following variables identified for oncology patients presenting to the ED: age, sex, cancer type, cancer stage, previous cancer treatment, previous hospitalization, presenting symptoms, treatment provided in the ED, admission and discharge data, and day, time, and length of ED visit.

SETTING

Community teaching hospital with annual ED census of 31,000.

PARTICIPANTS

All adult oncology patients who presented to the ED during the study period. We identified these patients by cross-referencing ED logs and tumor registry records.

RESULTS

Cancer history was identified for 284 of the 5,640 adult ED admissions (5%). Forty-three percent (n = 122) of the 284 patients with cancer history had an oncology-related ED visit. The most common symptoms of these patients were gastrointestinal (48%), pain (40%), neurologic (38%), cardiac (25%), and pulmonary (23%). Ten percent of patients with oncology-related ED visits died during the admission, and 48% died within 1 year of the ED visit.

CONCLUSION

Oncology patients present to the ED with symptoms of undiagnosed malignancy, complications of cancer treatment, and acute disease-related symptoms. Knowledge of an individual's cancer history and ability to recognize oncologic symptoms are important to the management of oncology patients.