RT Journal Article
SR Electronic
T1 Cancer Patients in the Emergency Department: A “Nightmare” that Might Become a Virtuous Clinical Pathway
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 6387
OP 6391
DO 10.21873/anticanres.12998
VO 38
IS 11
A1 JACOPO MARIA LEGRAMANTE
A1 STEFANIA PELLICORI
A1 ANDREA MAGRINI
A1 TIZIANA FRITTELLI
A1 VINCENZO FORMICA
A1 MARIO ROSELLI
YR 2018
UL http://ar.iiarjournals.org/content/38/11/6387.abstract
AB Background/Aim: Emergency departments (EDs) often face overcrowding issues while simultaneously confronting with the increasing clinical needs of patients, such as cancer patients, with both acute and chronic illnesses. In order to guarantee a prompt and specialized treatment of ED-attending cancer patients and reduce inappropriate inpatient admissions, a dedicated ED cancer pathway (EDCP) consisting of ED-bound Medical Oncology (MO) resident doctor and direct admission for candidate patients exclusively to the MO division was established at the Tor Vergata University Hospital in April 2015. Patients and Methods: Consecutive cancer patients attending the ED in two reference three-month periods were enrolled: pre-EDCP period, from 1st October 2014 to 31st December 2014, and post-EDCP period, from 1st October 2014 to 31st December 2015. Inpatient admission rate, mortality rate and both ED and inpatient length of stay were compared between the two analyzed periods, pre- and post-EDCP. Results: In the pre- and post-EDCP periods 127 and 123 cancer patients, respectively, were included. Most of the analyzed indicators were improved by EDCP implementation: Inpatient admission rate from 70% to 41% (p<0.0001), ED mortality rate from 10-4% (p=0.04), mean ED length of stay, from 58 to 42 h (p=0.03), mean inpatient length of stay, from 15.5 to 6.5 days (p<0.0001), in the pre- and post-EDCp period, respectively. Conclusion: EDCP implementation led to a significant improvement of health care delivery to cancer patients attending the Emergency Department.