Emergency department visits for symptoms experienced by oncology patients: a systematic review.
Digel Vandyk, Amanda
Harrison, Margaret B.
MetadataShow full item record
PURPOSE: The aim of this review was to explore the range and prevalence of cancer treatment or disease-related symptoms in the emergency department and their associated outcomes. METHODS: A systematic review examined studies cited in Medline, Embase, PsycINFO, and CINAHL published from 1980 to July 2011. Eligible studies measured emergency department visits for symptom assessment in adult oncology patients. Two reviewers independently screened citations and double data extraction was used. Descriptive analysis was conducted. RESULTS: Of 1,298 citations, six prospective and 12 retrospective descriptive studies were included. Of these, eight focused on multiple symptoms and 10 targeted specific symptoms. The studies were published between 1995 and 2011, conducted in seven countries, and had a median sample size of 143 (range 9-27,644). Of the 28 symptoms reported, the most common were febrile neutropenia, infection, pain, fever, and dyspnea. Definitions provided for individual symptoms were inconsistent. Of 16 studies reporting admission rates, emergency visits resulted in hospital admissions 58[NON-BREAKING SPACE]% (median) of the time in multi-symptom studies (range 31[NON-BREAKING SPACE]% to 100[NON-BREAKING SPACE]%) and 100[NON-BREAKING SPACE]% (median) of the time in targeted symptoms studies (range 39[NON-BREAKING SPACE]% to 100[NON-BREAKING SPACE]%). Of 11 studies reporting mortality rates, 13[NON-BREAKING SPACE]% (median) of emergency visits captured in multi-symptom studies (range 1[NON-BREAKING SPACE]% to 56[NON-BREAKING SPACE]%) and 20[NON-BREAKING SPACE]% (median) of visits in targeted symptoms studies (range 4[NON-BREAKING SPACE]% to 67[NON-BREAKING SPACE]%) resulted in death. CONCLUSIONS: Individuals with cancer present to emergency departments with a myriad of symptoms. Over half of emergency department visits resulted in hospital admissions. Few symptoms were defined adequately to compare data across studies, thereby revealing an important gap in cancer symptom reporting.
URI for this recordhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=22526151