Oncological emergencies: Profile and patient awareness of treatment

Abstract

Background: Patients with malignancies present to the emergency department (ED) with a varied spectrum of presentations. Data on oncological emergencies are scant; hence, we aimed to determine the profile, outcome, and awareness of their treatment of patients with malignancies presenting to the ED. Methodology: This prospective observational study was conducted in the adult ED of a large tertiary care hospital in South India between February and August of 2018. A convenient sample of patients presenting to the ED with a known or newly diagnosed malignancy was included in the study after obtaining written informed consent. Results: During the study, we recruited 110 patients presenting to the ED. The mean age of the patients was 48 (15.9) years. There was a female preponderance (56.4%). A quarter of the patients had malignancy of the genitourinary tract while 10% had breast carcinoma and 9% had bronchogenic carcinoma. Vomiting (44%) was the most common symptom at presentation followed by fever (39%) and abdominal pain (38%). Anemia (81%) and hyponatremia (54.5%) were the most common laboratory abnormalities. Antiemetics (61%), antibiotics (32%), and nonsteroidal anti-inflammatory drugs (27%) were the most commonly used medications. Chemotherapy-related complications (35.5%) and mass effects (28%) were the most common reasons for ED visits. The majority (83%) were previously diagnosed with malignancies. Most patients were aware of the duration (86%) and common side effects of chemotherapy (79%). However, most were unaware of the chemotherapy drugs' names (25%) and how to manage side effects (54%). Sixty percent required admission and three patients died during their in-hospital stay. Conclusion: Gastrointestinal symptoms and fever are the most common causes of presentation to the ED among patients with malignancies. Although most patients were aware of the duration and side effects of treatment, half of them were ignorant of the emergency first aid for side effects of the medications they were on.