Characteristics of the admissions of cancer patients to emergency department

Purpose: To identify the characteristics of admission of patients with cancer in the emergency department of a university hospital. Methods: The medical records of 468 emergency department admissions of 336 cancer patients due to medical conditions that were related either to their cancer or its treatment were reviewed and retrospectively analysed. Results: There were 226(67%) males and 110 females (37%), with a median age of 60 years (range 17-93). Regarding cancer staging, 156 (46%) patients had locoregional disease and 180 (54%) metastatic disease. Regarding performance status (PS), 321 (69%) were Eastern Cooperative Oncology Group (ECOG) 1-2, and 147 (31%) were ECOG 3-4. The main causes of emergency department admission were cancer progression in 188 (40%) patients, cancer-related signs and symptoms in 203 (43%) and treatment-related complications in 77 (16%). The most common primary cancer sites were the thorax, the gastrointestinal system and the genitourinary system. The medical condition necessitating emergency department admission was local tumor compression in 144 (31%) admissions, infection in 86 (19%) and end-of-life support in 63 (13%). Conclusion: Cancer patients seeking nonscheduled medical care and admitting to emergency departments present many challenges to the emergency physician. Due to the associated high morbidity and mortality, initial evaluation of the patient in the emergency department and therapy have utmost importance in the outcome of the patient. Accurate diagnosis and appropriate treatment of cancer-related problems can improve the quality of life dramatically in patients with cancer.