Pattern, Outcome and Associated Factors of Oncologic Emergencies Among Patients Visiting Saint Paul ‘s Hospital Millennium Medical College Adult Emergency Department: One Year Cross Sectional Study

Abstract

Introduction: Cancer patients are at high risk of developing a wide range of medical
emergencies.Patients with cancer face unique disease and treatment-related complications that prompt
frequent visits to the emergency department (ED), constituting a significant patient and
health care burden, resulting in more utilization of resources and ED overcrowding, which
may hamper the administration of quality and focused care.
Objective: The study aimed to assess the patterns, outcomes, and associated factors of
oncologic emergencies among patients visiting Saint Paul's Hospital Millennium Medical
College adult emergency department from March 1/2021, to April 30/2022.
Methods: A retrospective institutional-based cross-sectional study was used. Data was
collected using a standardized data extraction tool by trained data collectors from patient
medical records and health management information system registry books using a
systematic sampling method. A total of 173 cancer patients were included. Data was
analyzed using SPSS version 25.0.
Results: A total of 173 cancer patients were included in the study. The mean age of the
study participants was 53.05 ± 14.801 years. 56.6% were females, and 43.4% were males.
The most prevalent primary tumors were those of the gastrointestinal tract (49.7%) and
genitourinary system (19.1%). About 39.9% of the cases had metastasis. Only 39.3% of
cases started cancer treatment. Oncologic emergencies account for 68.8% of the cases. The
most frequently observed oncologic emergencies were structural (Mass effect) in 64.7% of
cases and hematologic emergencies in 34.45%. About 19.3% of patients with oncologic
emergencies have died. The commonest cause of death was due to Gastrointestinal
malignancies, seen in 34.6% of the cases. Those with Hematologic Emergencies had a 4.2
times risk of death as compared to patients with local mass effects (P value < 0.006).
Conclusion: Oncologic emergencies comprised 68.8% of the cases, of which 19.3% resulted
in mortality. There should be a well-organized system with chemotherapy, radiotherapy,
and palliative care facility service for patients with oncologic emergencies to reduce patient
mortality.