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. 2020 May 17;9(5):1505.
doi: 10.3390/jcm9051505.

EPICANCER-Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study

Olivier Peyrony  1 , Jean-Paul Fontaine  1 , Sébastien Beaune  2   3   4 , Abdo Khoury  4   5 , Jennifer Truchot  4   6   7 , Frédéric Balen  8   9 , Rishad Vally  10 , Jacques Schmitt  11 , Kasarra Ben Hammouda  12 , Mélanie Roussel  13 , Céline Borzymowski  14 , Cécile Vallot  15 , Veronique Sanh  16 , Elie Azoulay  17   18 , Sylvie Chevret  18   19
Affiliations

EPICANCER-Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study

Olivier Peyrony et al. J Clin Med. .

Abstract

Background: We aimed to estimate the prevalence of cancer patients who presented to Emergency Departments (EDs), report their chief complaint and identify the predictors of 30-day all-cause mortality.

Patients and methods: we undertook a prospective, cross-sectional study during three consecutive days in 138 EDs and performed a logistic regression to identify the predictors of 30-day mortality in hospitalized patients.

Results: A total of 1380 cancer patients were included. The prevalence of cancer patients among ED patients was 2.8%. The most frequent reasons patients sought ED care were fatigue (16.6%), dyspnea (16.3%), gastro-intestinal disorders (15.1%), trauma (13.0%), fever (12.5%) and neurological disorders (12.5%). Patients were admitted to the hospital in 64.9% of cases, of which 13.4% died at day 30. Variables independently associated with a higher mortality at day 30 were male gender (Odds Ratio (OR), 1.63; 95% CI, 1.04-2.56), fatigue (OR, 1.65; 95% CI, 1.01-2.67), poor performance status (OR, 3.00; 95% CI, 1.87-4.80), solid malignancy (OR, 3.05; 95% CI, 1.26-7.40), uncontrolled malignancy (OR, 2.27; 95% CI, 1.36-3.80), ED attendance for a neurological disorder (OR, 2.38; 95% CI, 1.36-4.19), high shock-index (OR, 1.80; 95% CI, 1.03-3.13) and oxygen therapy (OR, 2.68; 95% CI, 1.68-4.29).

Conclusion: Cancer patients showed heterogeneity among their reasons for ED attendance and a high need for hospitalization and case fatality. Malignancy and general health status played a major role in the patient outcomes. This study suggests that the emergency care of cancer patients may be complex. Thus, studies to assess the impact of a dedicated oncology curriculum for ED physicians are warranted.

Keywords: cancer; emergency department; epidemiology.

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Conflict of interest statement

All authors declare no potential conflict of interest related to the study.

Figures

Figure 1
Figure 1
Flowchart of cancer patients attending emergency departments in France throughout the 3-day study period (ED—emergency department; SAMU—Service d’Aide Médicale Urgente).
Figure 2
Figure 2
Reasons for cancer patients’ attendance to emergency departments.
Figure 3
Figure 3
In-hospital mortality rates depending on the reasons for attending emergency departments in hospitalized cancer patients.
Figure 4
Figure 4
Effects on the 30-day mortality of covariates identified by multivariate logistic regression after imputation of the missing data. * Reference: hematological malignancy.
See this image and copyright information in PMC

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