The following article features coverage from the 2021 ASCO Quality Care Symposium. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

A retrospective study found that patients with various cancers tended to go to the emergency department (ED) for predictable reasons, some of which could be avoided. These findings were presented during the 2021 ASCO Quality Care Symposium.

Reducing ED visits of patients with cancer would decrease healthcare costs and utilization, which is particularly relevant due to COVID-19. To understand patient motivations for going to the ED, researchers from Eastern Maine Medical Center retrospectively reviewed admissions data for 308 patients with solid malignancies who visited the ED between July 2019 and October 2020.

Patients visited the ED on 519 occasions. Of these, 184 involved the 111 patients with breast cancer, 186 involved the 102 patients with lung cancer, and 149 involved the 95 patients with gastrointestinal (GI) cancer.


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Hospital admission occurred with 53% of ED visits, with fewer admissions among patients with breast cancer (46%). However, hospital admissions occurred more frequently among patients with lung (60%) or GI (54%) cancer.

Among the patients with breast cancer, median age was 71 years and 20% of ED visits were due to a fall or injury. Patients with lung cancer visited the ED for respiratory complaints (24%), and those with GI cancer presented with gastrointestinal-related symptoms (24%). 

None of the ED visits by patients with breast cancer were related to cancer or chemotherapy; however, most of the ED visits by patients with lung or GI cancer were related to their cancer and/or treatment. ED visits were more likely to be a referral from the oncologists’ office in patients with lung or GI cancer than in patients with breast cancer (23% vs 11%).

Cancer/chemotherapy related respiratory and GI symptoms may be due to disease progression and therefore be unavoidable. But some ED visits by patients with cancer may be preventable, the researchers concluded. 

Several steps were taken in response to these trends. A systematic physical therapy assessment was developed for older patients with breast cancer. Palliative care consultations will be triggered earlier during disease progression. A “call us first” campaign was initiated to encourage patients to seek assessment and intervention prior to visiting the ED. 

Read more of Oncology Nurse Advisor’s coverage of the 2021 ASCO Quality Care Symposium by visiting the conference page.

Reference

Patwari A, Bhatlapenumarthi V, Brann C, et al. Analysis of reasons for emergency department (ED) visits and subsequent hospital admissions in patients with solid malignancies: a retrospective study from a cancer center in rural Maine. J Clin Oncol. 2021;39(suppl 28):abstr 241. doi:10.1200/JCO.2020.39.28_suppl.241