Emergency department visits among patients receiving systemic cancer treatment in the ambulatory setting

Abstract

Abstract Background Most patients receive systemic cancer treatment in the ambulatory setting. However, during their treatment journey, patients experience complications that necessitate emergency department (ED) visits. Few studies evaluated the burden of such visits and their characteristics. This study aimed to evaluate the incidence and characteristics of ED visits among adult cancer patients receiving systemic cancer treatment in the ambulatory setting. Methods A retrospective observational study was conducted at a comprehensive cancer center in Jordan. Utilizing the medical records database, we identified all patients treated in the chemotherapy infusion units, between January and December 2021. Patients who received only supportive therapy were excluded. The proportion of patients who required ED visits, their characteristics, types of cancer treatments received, and reasons for ED visits were recorded. Results Over the study period, 4985 patients received 38,803 treatment cycles in the infusion units. Among those, 2773 (55.6%) patients had 10,061 ED visits. Patients who presented to the ED had a mean age of 53.7 ± 13.8 (SD) years and 1763 (63.6%) were females. The most common types of malignancies were breast (39.5%) and gastrointestinal (20%). The most common cancer treatments associated with ED visits were platinum-based (24.8%), immune-mediated/targeted therapy (15.3%), and hormonal (12.3%). The most common admission diagnoses were neuromuscular/skeletal symptoms (34.8%) and gastrointestinal symptoms (20.2%). Conclusions In a large cohort of cancer patients receiving cancer treatment in the ambulatory setting, over half of them required at least one ED visit. Most visits were for neuromuscular/skeletal and gastrointestinal symptoms. Future studies should identify measures to reduce ED visits to enhance the patients’ quality of life and outcomes and optimize resources.