Reasons and Associated Factors for Emergency Room Visits of Cancer Patients in a Tertiary Hospital, Thailand

Abstract

Objective: To investigate the reasons leading cancer patients to visit an emergency room (ER) and the associated factors, which will suggest policies to reduce unnecessary ER visits. Material and Methods: A cross-sectional study was done in Songklanagarind Hospital, the major referral center in Southern Thailand. The data of cancer patients aged 18 years or older diagnosed during 2011 to 2018 were retrieved from our Hospital Information System. The reasons for the ER visits were defined and classified using the “chief complaints” from doctors’ notes. A negative binomial regression model was used to assess factors associated with the ER visits. Results: A total of 42,574 cancer patients were identified during the study period. 8,307 (19.5%) had visited the ER at least once. The most common cancer type was of the digestive organs (28.1%). The top 5 reasons for an ER visit were pain (25.4%), dyspnea (11.5%), abdominal discomfort (6.0%), fever (5.9%), and stoma and catheter device-related problems (5.2%). The most common factors associated with ER visits were age, metastasis, palliative chemotherapy or radiotherapy, previous hospitalization, years with cancer, type of cancer and healthcare scheme. Conclusion: Pain and dyspnea were the two most common chief complaints leading cancer patients to visit the ER. These two symptoms should be given special attention in cancer patients, especially those receiving chemotherapy or radiation, to ensure they are well controlled and do not lead to unnecessary ER visits.

Keywords

• cancer
• chief complaint
• er visits
• palliative care
• symptoms