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Impact of cancer on emergency department outcomes.

Publication ,  Journal Article
Qian, AS; Qiao, EM; Nalawade, V; Voora, RS; Kotha, NV; Dameff, C; Coyne, CJ; Murphy, JD
Published in: Journal of Clinical Oncology
May 20, 2021

e18618 Background: Cancer patients frequently utilize the Emergency Department (ED) for a variety of diagnoses, both related and unrelated to their cancer. Patients with cancer have unique risks related to their cancer and treatment which could influence ED-related outcomes. A better understanding of these risks could help improve risk-stratification for these patients and help inform future interventions. This study sought to define the increased risks cancer patients face for inpatient admission and hospital mortality among cancer patients presenting to the ED. Methods: From the National Emergency Department Sample (NEDS) we identified patients with and without a diagnosis of cancer presenting to the ED between 2016 and 2018. We used International Classification of Diseases, version 10 (ICD10-CM) codes to identify patients with cancer, and to identify patient’s presenting diagnosis. Multivariable mixed-effects logistic regression models assessed the influence of cancer diagnoses on two endpoints: hospital admission from the ED, and inpatient hospital mortality. Results: There were 340 million weighted ED visits, of which 8.3 million (2.3%) occurred in patients with a cancer diagnosis. Compared to non-cancer patients, patients with cancer had an increased risk of inpatient admission (64.7% vs. 14.8%; p < 0.0001) and hospital mortality (4.6% vs. 0.5%; p < 0.0001). Factors associated with both an increased risk of hospitalization and death included older age, male gender, lower income level, discharge quarter, and receipt of care in a teaching hospital. We identified the top 15 most common presenting diagnoses among cancer patients, and among each of these diagnoses, cancer patients had increased risks of hospitalization (odds ratio [OR] range 2.0-13.2; all p < 0.05) and death (OR range 2.1-14.4; all p < 0.05) compared to non-cancer patients with the same diagnosis. Within the cancer patient cohort, cancer site was the most robust individual predictor associated with risk of hospitalization or death, with highest risk among patients with metastatic cancer, liver and lung cancers compared to the reference group of prostate cancer patients. Conclusions: Cancer patients presenting to the ED have high risks for hospital admission and death when compared to patients without cancer. Cancer patients represent a distinct population and may benefit from cancer-specific risk stratification or focused interventions tailored to improve outcomes in the ED setting.

Duke Scholars

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

May 20, 2021

Volume

39

Issue

15_suppl

Start / End Page

e18618 / e18618

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Qian, A. S., Qiao, E. M., Nalawade, V., Voora, R. S., Kotha, N. V., Dameff, C., … Murphy, J. D. (2021). Impact of cancer on emergency department outcomes. Journal of Clinical Oncology, 39(15_suppl), e18618–e18618. https://doi.org/10.1200/jco.2021.39.15_suppl.e18618
Qian, Alexander S., Edmund M. Qiao, Vinit Nalawade, Rohith S. Voora, Nikhil V. Kotha, Christian Dameff, Christopher John Coyne, and James Don Murphy. “Impact of cancer on emergency department outcomes.Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18618–e18618. https://doi.org/10.1200/jco.2021.39.15_suppl.e18618.
Qian AS, Qiao EM, Nalawade V, Voora RS, Kotha NV, Dameff C, et al. Impact of cancer on emergency department outcomes. Journal of Clinical Oncology. 2021 May 20;39(15_suppl):e18618–e18618.
Qian, Alexander S., et al. “Impact of cancer on emergency department outcomes.Journal of Clinical Oncology, vol. 39, no. 15_suppl, American Society of Clinical Oncology (ASCO), May 2021, pp. e18618–e18618. Crossref, doi:10.1200/jco.2021.39.15_suppl.e18618.
Qian AS, Qiao EM, Nalawade V, Voora RS, Kotha NV, Dameff C, Coyne CJ, Murphy JD. Impact of cancer on emergency department outcomes. Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2021 May 20;39(15_suppl):e18618–e18618.

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

May 20, 2021

Volume

39

Issue

15_suppl

Start / End Page

e18618 / e18618

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences