Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department.
Sule YilmazCorita R GrudzenDanielle D DurhamCaroline McNaughtonIsabelle MarcelinBeau AbarDavid AdlerAveh BastaniChristopher W BaughSteven L BernsteinJason J BischofChristopher J CoyneDaniel J HenningMatthew F HudsonAdam KlotzGary H LymanTroy E MadsenDaniel J PallinCielito Reyes-GibbyJuan Felipe RicoRichard J RyanNathan I ShapiroRobert SworCharles R ThomasArvind VenkatJason WilsonSai-Ching Jim YeungJeffrey M CaterinoPublished in: Journal of palliative medicine (2022)
Background: Older adults with cancer use the emergency department (ED) for acute concerns. Objectives: Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. Design: A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data. Settings/Subjects: Cancer patients who presented to the 18 CONCERN affiliated EDs in the United States. Measurements: Survey included demographics, cancer type, functional status, symptom burden, palliative and hospice care enrollment, and advance directive code status. Results: Of the total (674/1075, 62.3%) patients had advanced cancer and most were White (78.6%) and female (50.3%); median age was 64 (interquartile range 54-71) years. A small proportion of them were receiving palliative (6.5% [95% confidence interval; CI 3.0-7.6]; p = 0.005) and hospice (1.3% [95% CI 1.0-3.2]; p = 0.52) care and had a higher 30-day mortality rate (8.3%, [95% CI 6.2-10.4]). Conclusions: Patients with advanced cancer continue to present to the ED despite recommendations for early delivery of palliative care.
Keyphrases
- palliative care
- advanced cancer
- emergency department
- papillary thyroid
- squamous cell
- end stage renal disease
- chronic kidney disease
- ejection fraction
- electronic health record
- newly diagnosed
- risk factors
- prostate cancer
- cardiovascular events
- type diabetes
- young adults
- cardiovascular disease
- prognostic factors
- health insurance
- patient reported
- chronic pain
- patient reported outcomes
- mechanical ventilation