Clinical Profiles and Reasons for Emergency Department Presentation Among Oncology Patients-A Retrospective Two-Center Study in Poland.

Background/

Objectives

Cancer patients increasingly present to emergency departments, posing unique clinical and organizational challenges. Data on this population in Poland remain limited.

Methods

A retrospective study was conducted in two hospitals in northern Poland (January-March 2023). All adult patients with active cancer presenting to the ED were included (n = 552, 3.1% of visits). Data included demographics, cancer type, presenting complaints, Emergency Severity Index (ESI), disposition, and in-hospital mortality. Multivariable logistic regression models were used to assess predictors of hospitalization, hospice referral, and mortality, reported as odds ratios (ORs) with 95% confidence intervals (CIs).

Results

Mean age was 68 years; 51% were female. The most common cancers were lung, breast, colorectal, and prostate. Leading complaints included abdominal pain (15%), trauma (7.5%), and dyspnea (7%). Most patients were triaged as ESI 3-4 (87%). Hospitalization rate was 58%, hospice referral 6%, and in-hospital mortality 7.1%. Lower ESI levels were significantly associated with hospitalization (OR 0.57; 95% CI 0.44-0.73), hospice referral (OR 0.40; 95% CI 0.25-0.63), and in-hospital mortality (OR 0.29; 95% CI 0.18-0.47).

Conclusions

Oncology patients represent a small but high-risk ED population. While ESI reflects acute severity, it may not adequately capture palliative care needs. These findings suggest opportunities to improve integration of palliative care in ED settings.