Analysis of gynecologic cancer patients visiting emergency department: a population-based cohort study in Taiwan

Purpose: To investigate the characteristics of gynecologic cancer patients visiting the emergency department (ED). Materials and Methods: A retrospective cohort of gynecologic cancer patients in ED visits from 2000 to 2012 was analyzed using the Longitudinal Health Insurance Database 2000 (LHID2000) which randomly selected 1,000,000 beneficiaries from the year 2000 Registry of Beneficiaries (n = 23.72 million). Results: There were 5,893 ED visits by 1,400 gynecologic cancer patients. The mean age was 55.22 14.60 years. The mean number of ED visits was 4.21 +/- 5.18. 657 (46.93%) patients that were admitted to hospital; 70.57% ED visits occurred in medical center. Abdominal pain (19.04%), complications of surgical and medical care (13.28%) and intestinal obstruction without mention of hernia (10.69%) are the most three common presenting symptoms except other symptoms, signs, and ill-defined conditions (24.79%); 62.56% of the medications prescribed in ED visits are of gastrointestinal category. The overall survival rate of ED visits was significantly lower than that of no ED visits (p < 0.0001). Conclusions: Relatively low rate of hospital admission may indicate unnecessary ED visits resulting in healthcare costs. Abdominal pain is the most common specific symptoms at presentation. Most medications belong to the gastrointestinal category reminding us of the importance of nutrition support. ED visits were a significant poor prognostic factor for overall survival.