Unplanned presentations to emergency departments due to chemotherapy induced complications: Opportunities for improving service delivery

SummaryAimTo understand the key characteristics of emergency department (ED) presentations among newly diagnosed cancer patients undergoing chemotherapy in outpatient settings.MethodsA retrospective audit of 443 randomly selected newly diagnosed cancer patients who received chemotherapy through day oncology and presented to an ED in 2007. Data were collected from the Victorian Emergency Minimum Dataset and medical record review. Descriptive statistics, chi-square, t-tests and logistic regression, were used to analyse the data.ResultsThere were slightly more males than females (53.0% and 47.0%, respectively); the mean age was 61 years (SD = 12; range 22—89 years). The main cancer diagnoses were lymphoma/leukaemia (17.5%); breast (14.7%); lung (11.3%); and gallbladder, liver, or pancreas (5.3%). Febrile neutropenia (15%) was the most common ED discharge diagnosis and it was also the diagnosis (82.8%) most likely to result in a hospital admission. Diarrhoea/constipation (52.9%) were the ED diagnoses least likely to result in hospital admission.ConclusionsStrategies to reduce preventable presentations would not only benefit patients but reduce additional health care costs associated with chemotherapy treatment. A specialist liaison or coordinating role within health services, providing continuity of care, during the course of patients’ chemotherapy treatment, has the potential to reduce unplanned presentations to EDs, improve service delivery and reduce health care costs.