Outcomes Worse for Cancer Patients Seen at Noncancer EDs
TUESDAY, April 23, 2019 -- Patients with cancer who are seeking cancer-related emergency medical care have worse outcomes when they are seen at alternative hospitals or those not associated with a cancer center, according to a study published in the April 23 issue of CMAJ, the journal of the Canadian Medical Association.
Keerat Grewal, M.D., from the Schwartz/Reisman Emergency Medicine Institute in Toronto, and colleagues conducted a retrospective cohort study involving 42,820 cancer patients aged 20 years and older. Outcomes were compared for patients seen in an emergency department at an alternative hospital (not the site where cancer treatment was given) versus their original hospital and for those seen at an alternative emergency department in a general hospital (not a cancer center) versus their original hospital or a cancer center.
The researchers found that compared with patients seen at original hospitals, those seen at alternative hospitals were less likely to be admitted to the hospital (odds ratio, 0.78) and had a higher risk for return visits to the emergency department (hazard ratio, 1.06). Compared with matched counterparts, patients at alternative general hospitals had lower odds of admission to the hospital (odds ratio, 0.83) and an elevated risk for return visits to the emergency department (hazard ratio, 1.07); they also had higher 30-day mortality (odds ratio, 1.13) and lower odds of computed tomography imaging (odds ratio, 0.74).
"These results suggest that the cancer expertise of an institution is an important predictor of outcomes in the emergency care of patients with cancer," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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Posted: April 2019