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Observational Study
. 2023 May 8;13(5):e070320.
doi: 10.1136/bmjopen-2022-070320.

Retrospective study of cancer patients' predictive factors of care in a large, Hungarian tertiary care centre

Márton Koch #  1 , Éva Szabó #  2 , Csaba Varga  1   3 , Viktor Soós  1 , Lilla Prenek  1 , Lili Porcsa  1 , Szabolcs Bellyei  4 , Kyra Girán  5 , János Girán  6 , István Kiss  6 , Éva Pozsgai  7   8
Affiliations
Observational Study

Retrospective study of cancer patients' predictive factors of care in a large, Hungarian tertiary care centre

Márton Koch et al. BMJ Open. .

Abstract

Objectives: To identify predictive factors of multiple emergency department (ED) visits, hospitalisation and potentially preventable ED visits made by patients with cancer in a Hungarian tertiary care centre.

Design: Observational, retrospective study.

Setting: A large, public tertiary hospital, in Somogy County, Hungary, with a level 3 emergency and trauma centre and a dedicated cancer centre.

Participants: Patients above 18 years with a cancer diagnosis (International Classification of Diseases, 10th Revision codes of C0000-C9670) who visited the ED in 2018, who had received their diagnosis of cancer within 5 years of their first ED visit in 2018 or received their diagnosis of cancer latest within the study year. Cases diagnosed with cancer at the ED (new cancer diagnosis-related ED visits) were also included, constituting 7.9% of visits.

Primary outcome measures: Demographic and clinical characteristics were collected and the predictors of multiple (≥2) ED visits within the study year, admission to inpatient care following the ED visit (hospitalisation), potentially preventable ED visits and death within 36 months were determined.

Results: 2383 ED visits made by 1512 patients with cancer were registered. Predictive factors of multiple (≥2) ED visits were residing in a nursing home (OR 3.09, 95% CI 1.88 to 5.07) and prior hospice care (OR 1.87, 95% CI 1.05 to 3.31). Predictive factors for hospitalisation following an ED visit included a new cancer diagnosis-related visit (OR 1.86, 95% CI 1.30 to 2.66) and complaint of dyspnoea (OR 1.61, 95% CI 1.22 to 2.12).

Conclusions: Being a resident of a nursing home and receiving prior hospice care significantly increased the odds of multiple ED visits, while new cancer-related ED visits independently increased the odds of hospitalisation of patients with cancer. This is the first study to report these associations from a Central-Eastern European country. Our study may shed light on the specific challenges of EDs in general and particularly faced by countries in the region.

Keywords: accident & emergency medicine; adult oncology; organisation of health services.

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Conflict of interest statement

Competing interests: None declared.

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