Emergency Visits in Cancer Patients: Predictors of Hospitalization and Palliative Care Needs

Patterns of Emergency Department Utilization Among Cancer Patients: A Retrospective Cohort Study Evaluating Predictors of Hospitalization and Mortality

Abstract

Background: Cancer patients frequently visit emergency departments due to acute complications related to their disease or treatment. Identifying visit patterns and predictors of adverse outcomes can guide targeted interventions to improve care and reduce emergency reliance.

Material-Methods: This retrospective cohort study analyzed visit patterns, common complaints, and predictors of hospitalization and mortality among cancer patients at a tertiary hospital. We reviewed 753 patients with active cancer who visited the emergency department. Data on demographics, clinical presentation, admissions, and mortality were analyzed. Logistic regression identified predictors of hospitalization, and mortality rates were assessed based on visit frequency.

Results: Among 1609 visits, gastrointestinal (36.5%) and respiratory (20.7%) cancers were the most common. Abdominal pain (18.15%) and nausea/vomiting (18.09%) were leading complaints. Hospitalization occurred in 34.6% of visits. Significant predictors included anorexia-cachexia (OR=3.84, 95% CI: 2.18–6.77, p<.001), altered mental status (OR=3.14, 95% CI: 1.81–5.44, p<.001), shortness of breath (OR=2.15, 95% CI: 1.52–3.03, p<.001), fever (OR=1.86, 95% CI: 1.40–2.48, p<.001), and abdominal pain (OR=1.61, 95% CI: 1.22–2.12, p<.001). The two-year mortality rate was 20.19%, highest in gastric (32.65%), pancreatic (25.0%), and lung cancers (24.8%). Patients with ≥5 visits had a 25% mortality rate.

Conclusion: Cancer patients frequently visit emergency services, and anorexia-cachexia, altered mental status, shortness of breath, fever, and abdominal pain increase the hospitalization and mortality risks. Recurrent visits (≥5) have higher mortality, highlighting the need for better palliative care integration and strategies to reduce emergency dependence for this vulnerable population.