Emergency department utilization and clinical outcomes among patients with gastrointestinal cancers receiving chemotherapy during the first year after diagnosis.

PURPOSE: The purpose of this study was to evaluate Emergency Department (ED) utilization and associated outcomes among patients with gastrointestinal (GI) cancers during the first year following diagnosis.

METHODS

This retrospective study was conducted at a comprehensive cancer center and included patients with GI cancers diagnosed between 2018 and 2022 who received chemotherapy. Data collected included baseline characteristics, cancer type and stage, initial treatment plan, and prescribed chemotherapy with number of cycles received. Also, we evaluated ED visits frequency, presenting complaints, hospital admissions, and 1-year mortality.

RESULTS

During the study period, a total of 2278 patients were diagnosed with GI cancers and received chemotherapy. The mean age was 57 ± 12.4 (SD), 57.6% were males, and 23.6% were smokers. The majority had colon cancer (n = 769, 33.7%) and rectal cancer (n = 630, 27.6%). The most common Surveillance, Epidemiology, and End Results (SEER) stage was distant (43.7%). Renal and hepatic dysfunction at baseline were recorded in 5.6% and 2.8%, respectively. Surgery combined with chemotherapy was the most common treatment plan (43.2%), and patients received a median (IQR) of 8 (5-12) chemotherapy cycles. Among those patients, 2007 (88.1%) required at least one ED visit, with a median (IQR) of 3 (1-6) visits/patient, and 1971 (86.5%) required at least one hospital admission. The most frequently reported chief complaints were musculoskeletal/pain, GI symptoms, and infections. The 1-year mortality rate was 48.8%.

CONCLUSION

In a large cohort of patients with GI cancers, the majority required ED visits within the first-year following diagnosis, many of which resulted in hospital admissions. Most visits were for musculoskeletal/pain and GI symptoms.