Abdominal cancer pain admission in emergency department vs. oncology emergency department.

Abstract

Objective: To investigate the rates of hospitalization, opioid prescription, supportive care, hospice referral, and 30-day all-cause mortality in patients with metastatic cancer and abdominal pain admitted to either the Emergency Department (ED) or the Oncology ED.

Methods: We conducted a retrospective cohort study of patients with metastatic cancer and abdominal pain admitted to the ED or Oncology ED at a tertiary medical center between June 2020 and May 2022. The MDClone ADAMS Platform, a healthcare data analytics environment, was used for data collection. Inverse probability weighting (IPW) based on propensity scoring was used to balance and compare characteristics of patient groups admitted to both ED settings.

Results: Weighted multivariable logistic regression found that metastatic cancer patients with abdominal pain complaints visiting the Oncology ED were 66% less likely to be admitted to the hospital (OR 0.34, 95% CI [0.16, 0.72], p-value = 0.005), and more likely to receive a supportive care consultation (OR 4.67, 95% CI [1.45, 15.05], p-value = 0.010), compared with the ED. Our study found that an Oncology ED, due to its expertise and immediate access to supportive care services due to their physical location within the same facility, enables prompt intervention for symptom management and psychosocial support, besides providing further oncology outpatient clinics follow-up for patients with metastatic cancer.

Conclusions: We believe that a developed oncology emergency care with specialized staff has the potential to reduce hospitalization rates.