Lung cancer patients frequently visit the emergency room for cancer‑related and -unrelated issues

Kotajima,Futoshi; Kobayashi,Kunihiko; Sakaguchi,Hirozo; Nemoto,Manabu

doi:10.3892/mco.2014.241

March-April 2014 Volume 2 Issue 2

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March-April 2014 Volume 2 Issue 2

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Article

Lung cancer patients frequently visit the emergency room for cancer‑related and -unrelated issues

Authors:
- Futoshi Kotajima
- Kunihiko Kobayashi
- Hirozo Sakaguchi
- Manabu Nemoto
View Affiliations / Copyright

Affiliations: Department of Emergency and Trauma Care, Saitama Medical University International Medical Center, Hidaka, Saitama 350‑1298, Japan, Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama 350‑1298, Japan, Department of Chest Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama 350‑1298, Japan
Pages: 322-326
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Published online on: January 13, 2014

https://doi.org/10.3892/mco.2014.241
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Abstract

Lung cancer patients visit the emergency room (ER) for cancer‑related and -unrelated reasons more often compared to patients with other types of cancer. This results in increased admissions and deaths in the ER. in this study, we retrospectively reviewed the characteristics of lung cancer patients visiting the ER in order to optimize the utilization of emergency medical services and improve the patients' quality of life. Lung cancer patients visiting the ER of a single institution over a 2‑year period (2010‑2011) were analyzed. The patients' chief complaints and diagnoses at presentation in the ER were classified as cancer‑related and ‑unrelated. Hospital admission, discharge from the ER, hospital mortality and survival of advanced lung cancer patients hospitalized through admission to the ER was surveyed. A total of 113 patients visited the ER 143 times. Seventy visits (49.0%) were cancer‑related and 73 (51.0%) were cancer‑unrelated. Respiratory symptoms, pain, gastrointestinal and neurological events and fever were the most common cancer‑related issues recorded. With the progression of cancer stage, the number of ER visits, admissions, ambulance use and hospital mortalities increased. In visits due to cancer‑unrelated issues, including infection, cardiovascular and gastrointestinal diseases, fever was the most common complaint. Emergency admissions of advanced‑stage patients for cancer‑related issues revealed a significantly shorter median survival time compared to that for patients admitted for cancer‑unrelated issues (61 vs. 406 days, respectively; P<0.05). It was observed that outpatients with lung cancer visited the ER for cancer‑related and -unrelated reasons with a similar frequency. Therefore, accurate differential diagnosis in the ER is crucial for patients with lung cancer.

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1	Barbera L, Taylor C and Dudgeon D: Why do patients with cancer visit the emergency department near the end of life? CMAJ. 182:563–568. 2010. View Article : Google Scholar : PubMed/NCBI
2	Leak A, Mayer DK, Wyss A, Travers D and Waller A: Why do cancer patients die in the emergency department? An analysis of 283 deaths in NC EDs. Am J Hosp Palliat Care. 30:178–182. 2013. View Article : Google Scholar : PubMed/NCBI
3	Mayer DK, Travers D, Wyss A, Leak A and Waller A: Why do patients with cancer visit emergency departments? Results of a 2008 population study in North Carolina. J Clin Oncol. 29:2683–2688. 2011. View Article : Google Scholar : PubMed/NCBI
4	Temel JS, McCannon J, Greer JA, et al: Aggressiveness of care in a prospective cohort of patients with advanced NSCLC. Cancer. 113:826–833. 2008. View Article : Google Scholar : PubMed/NCBI
5	Slatore CG, Cecere LM, Letourneau JL, et al: Intensive care unit outcomes among patients with lung cancer in the surveillance, epidemiology, and end results-medicare registry. J Clin Oncol. 30:1686–1691. 2012. View Article : Google Scholar : PubMed/NCBI
6	McKenzie H, Hayes L, White K, et al: Chemotherapy outpatients’ unplanned presentations to hospital: a retrospective study. Support Care Cancer. 19:963–969. 2011.
7	Cull LF and Nolan MB: Treating neutropenic fever in the emergency department: delays may be deadly! J Emerg Nurs. 35:36–39. 2009.PubMed/NCBI
8	Gonsalves WI, Tashi T, Krishnamurthy J, et al: Effect of palliative care services on the aggressiveness of end-of-life care in the Veteran’s Affairs cancer population. J Palliat Med. 14:1231–1235. 2011.PubMed/NCBI
9	Volpicelli G and Frascisco M: Lung ultrasound in the evaluation of patients with pleuritic pain in the emergency department. J Emerg Med. 34:179–186. 2008. View Article : Google Scholar : PubMed/NCBI
10	Morrison LK, Harrison A, Krishnaswamy P, Kazanegra R, Clopton P and Maisel A: Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea. J Am Coll Cardiol. 39:202–209. 2002. View Article : Google Scholar : PubMed/NCBI
11	Schwam E: B-type natriuretic peptide for diagnosis of heart failure in emergency department patients: a critical appraisal. Acad Emerg Med. 11:686–691. 2004. View Article : Google Scholar : PubMed/NCBI
12	Barbera L, Paszat L and Chartier C: Indicators of poor quality end-of-life cancer care in Ontario. J Palliat Care. 22:12–17. 2006.PubMed/NCBI
13	Escalante CP, Martin CG, Elting LS, et al: Dyspnea in cancer patients. Etiology, resource utilization, and survival-implications in a managed care world. Cancer. 78:1314–1319. 1996.PubMed/NCBI
14	Escalante CP, Martin CG, Elting LS, et al: Identifying risk factors for imminent death in cancer patients with acute dyspnea. J Pain Symptom Manage. 20:318–325. 2000. View Article : Google Scholar : PubMed/NCBI
15	Geraci JM, Tsang W, Valdres RV and Escalante CP: Progressive disease in patients with cancer presenting to an emergency room with acute symptoms predicts short-term mortality. Support Care Cancer. 14:1038–1045. 2006. View Article : Google Scholar : PubMed/NCBI
16	Burge F, Lawson B and Johnston G: Family physician continuity of care and emergency department use in end-of-life cancer care. Med Care. 41:992–1001. 2003. View Article : Google Scholar : PubMed/NCBI
17	Barbera L, Paszat L and Qiu F: End-of-life care in lung cancer patients in Ontario: aggressiveness of care in the population and a description of hospital admissions. J Pain Symptom Manage. 35:267–274. 2008. View Article : Google Scholar : PubMed/NCBI
18	Yates M and Barrett A: Oncological emergency admissions to the Norfolk and Norwich University Hospital: an audit of current arrangements and patient satisfaction. Clin Oncol (R Coll Radiol). 21:226–233. 2009. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Lung cancer patients frequently visit the emergency room for cancer‑related and -unrelated issues

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