Emergency department cancer unit and management of oncologic emergencies: experience in Asan Medical Center

Abstract

Purpose: With the increasing incidence of cancer patients, our institute set up an emergency department (ED) unit for cancer (cancer emergency room, CER). We intended to clarify the operating characteristics and administrative benefits of the CER.

Methods: The CER was opened in May 2009. Retrospective review of all patients managed in the CER from January 2010 to December 2010 was performed, and data of the patients during January 2008 to December 2008 were collected to compare the care before and after the introduction of the CER.

Results: A total of 5,502 cancer patients visited the CER during 2010; 88.8% had solid tumor and 11.2% had hematologic malignancies. Diagnosis was grouped into four categories: disease progression (55.5%), infection (22.8%), treatment-related complications (14.7%), and noncancer-related problems (7%). Common treatments included antibiotic administration (28.9%), pain control (22.9%), and drainage procedures (16.2%). Of the 5,502 patients, 52.7% were discharged, 0.2% died during the stay, home service was supplied to 0.6% for palliative care, and 4.5% were transferred to other hospitals including hospice care center. When compared with the year 2008, inpatient unit admission decreased, cost of care in both ED and inpatient unit was reduced (all P values <0.05). However, length of stay in ED and inpatient unit was not different.

Conclusion: ED unit for cancer has a valuable role in managing patients with cancers, not only progression of disease but also various toxicities related to its treatments.