Clinical analysis of the cancer patients who admitted to the emergency room

Abstract

Objective: Patients with cancer diagnosis often admit to emergency room with complaints that are directly or indirectly related to their current condition. We aimed to analyze what complaints the cancer patients admit with most, how long the cancer patients who are treated with antitumor treatment admit to the emergency room after the antitumor treatment, which departments were consulted with these patients most and the outcomes of these patients in the emergency room.

Method: In this study, 1946 male and female patients older than 18 years old with oncological diseases who admitted to the emergency room for any complaints were analyzed retrospectively.

Results: 879 (45.2%) of the patients were females and 1067 (54.8%) of them were males. The mean age was 59.1. The most common complaint was abdominal pain with 344 (17.7%) patients. The most common malignancy was lung cancer with 335 (17.3%) patients. 610 (31.3%) of the patients in the study were still receiving chemotherapy whereas 1052 (54%) of the patients never had chemotherapy. 285 (14.6%) patients were not receiving chemotherapy although they previously had. It was found that the patients admitted to the emergency room a mean of 69.9 days after the chemotherapy. 651 (33.5%) of the patients were not consulted with any departments whereas other patients were consulted with other departments, with medical oncology being the most consulted department. 1017 (52.2%) patients were discharged from the emergency room and 895 (46%) patients were hospitalized. 33 patients (1.7%) died in the emergency room.

Conclusions: Patients with lung cancer admitted to the emergency rooms more often. Cancer patients admitted to the emergency department with abdominal pain and shortness of breath most. Emergency physicians have increased responsibility for tests, treatment and hospitalization of these patients as the patients are generally older and have multiple conditions.

Keywords Cancer, Emergency room, Oncology.

Introduction Death caused by cancer is the second most common reason after cardiovascular causes in our country, Turkey. With the increase in older population, an increase in new cancer cases and side effects of cancer treatment are expected [1]. This increase affects emergency rooms as well as oncology departments in terms of volume and work force. Cancer patients can admit to emergency rooms for complaints caused by their condition like pain, bleeding and respiratory distress as well as the metabolic, infectious and endocrine problems caused by their condition. In addition to this, these patients can admit for febrile neutropenia or hypersensitivity reactions caused by antitumor medication administered for their treatment, or malnutrition or lack of care caused by inadequacy of social conditions. They also can admit to the hospital for trauma, cardiovascular diseases, pulmonary diseases and other conditions that are not caused by cancer [2,3]. Usually, the benefits of emergency rooms to the cancer patients are more than expected.

We aimed to analyze what complaints the cancer patients admit with most, how long the cancer patients who are treated with antitumor treatment admit to the emergency room after the antitumor treatment, which departments were consulted with these patients most and the outcomes of these patients in the emergency room in a period of one year.