RECOGNITION AND EVALUATION OF ONCOLOGY-RELATED SYMPTOMS IN THE EMERGENCY DEPARTMENT

Study objective: To identify the oncology patient population presentin g to the emergency department and examine the causes and clinical mana gement of oncology symptoms in the ED. Design: Retrospective review of 5,640 adult patients, with the following variables identified for onc ology patients presenting to the ED: age, sex, cancer type, cancer sta ge, previous cancer treatment, previous hospitalization, presenting sy mptoms, treatment provided in the ED, admission and discharge data, an d day, time, and length of ED visit. Setting: Community teaching hospi tal with annual ED census of 31,000. Participants: All adult oncology patients who presented to the ED during the study period. We identifie d these patients by cross-referencing ED logs and tumor registry recor ds. Results: Cancer history was identified for 284 of the 5,640 adult ED admissions (5%). Forty-three percent (n=122) of the 284 patients wi th cancer history had an oncology-related ED visit. The most common sy mptoms of these patients were gastrointestinal (48%), pain (40%), neur ologic (38%), cardiac (25%), and pulmonary (23%). Ten percent of patie nts with oncology-related ED visits died during the admission, and 48% died within 1 year of the ED visit. Conclusion: Oncology patients pre sent 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 symp toms are oncology-related symptoms in the emergency department.