Abstract
Goals of work
Since emergency departments (ED) are designed to manage people with urgent and life-threatening conditions, cancer patients presenting with pain may not receive the appropriate care in the ED. The purpose of this study was to identify the incidence and factors related to ED visits by cancer patients with pain complaints.
Materials and methods
Medical charts selected by stratified random sampling were retrospectively reviewed to obtain information about ED visits by cancer patients during a 1-year period. The sample included 1,179 ED visits by 1,026 cancer patients.
Main results
Pain was the most common reason for ED visits by cancer patients. The incidence of ED visits for pain as a presenting problem was 27.8%. The 72-h ED return-visit rate was 8.2% for cancer patients who visited the ED with pain complaints. Patients with gastrointestinal and genitourinary cancers were more likely to visit the ED for pain. Patients who had received radiation therapy were less likely to visit the ED for pain.
Conclusion
Effective cancer pain management programs need to be developed and tested to reduce ED visits by cancer patients with pain. More research is needed to explore why cancer patients with pain visit the ED.
Similar content being viewed by others
References
Barbera L, Paszat L, Chartier C (2006) Indicators of poor quality end-of-life cancer care in Ontario. J Palliat Care 22:12–17
De Luigi A (2002) Analysis of reasons for admission to the emergency department for cancer patients. Ann Oncol 13:112
Diaz-Couselo FA, O'Connor JM, Nervo A, Tossen G, Guercovich A, Puparelli C, Coronado C, Costanzo V, Zylberman M (2004) Non-scheduled consultation in oncologic patients. How many of them are true emergencies? An observational prospective study. Support Care Cancer 12:274–277. doi:10.1007/s00520-003-0584-z
DOH (2006) National Health Insurance Annual Statistics. Executive Yuan, Taiwan, Taipei
Fortun MT, Encina Y, Etxebarria MJ, Escudero JM, Bardon AI, Martinez S (2004) The oncology patient in emergencies. Epidemiological data. An Sist Sanit Navar 27(Suppl 3):9–16
Kurtz ME, Kurtz JC, Given CW, Given B (2006) Effects of a symptom control intervention on utilization of health care services among cancer patients. Med Sci Monit 12:CR319–CR324
Lai CC (2004) The analysis of emergency medical resources utilization and patient revisits to the emergency department in Taiwan. National Taiwan University, Taipei, p 100
Lee SY, Kung CT, Lee WH (2007) Cluster utilization of emergency department services by frequent uses in a medical center. J Taiwan Emerg Med 9:39–46
Lerman B, Kobernick MS (1987) Return visits to the emergency department. J Emerg Med 5:359–362. doi:10.1016/0736-4679(87)90138-7
Liaw SJ, Bullard MJ, Hu PM, Chen JC, Liao HC (1999) Rates and causes of emergency department revisits within 72 hours. J Formos Med Assoc 98:422–425
Ripamonti C, Bruera E (2002) Palliative management of malignant bowel obstruction. Int J Gynecol Cancer 12:135–143. doi:10.1046/j.1525-1438.2002.01103.x
Ripamonti C, Twycross R, Banes M, Bozzetti F, Capri S, De Conno F, Gemlo B, Hunt TM, Krebs H, Mercadante S, Schaerer R, Wilkinson P (2001) Clinical-practice recommendations for the management of bowel obstruction in patients with end-stage cancer. Support Care Cancer 9:223–233. doi:10.1007/s005200000198
Ripamonti CI, Easson AM, Gerdes H (2008) Management of malignant bowel obstruction. Eur J Cancer 44:1105–1115. doi:10.1016/j.ejca.2008.02.028
Swenson KK, Rose MA, Ritz L, Murray CL, Adlis SA (1995) Recognition and evaluation of oncology-related symptoms in the emergency department. Ann Emerg Med 26:12–17. doi:10.1016/S0196-0644(95)70231-8
Tang ST, Wu SC, Hung YN, Huang EW, Chen JC, Liu TW (2009) Trends in quality of end-of-life care for Taiwanese cancer patients who died in 2000–2006. Ann Oncol 20:343–348. doi:10.1093/annonc/mdn602
Tsai MC, Chen HH (2002) Pain management in the emergency department. J Emerg Crit Care Med 13:139–154
van den Beuken-van Everdingen MHJ, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J (2007) High prevalence of pain in patients with cancer in a large population-based study in The Netherlands. Pain 132:312–320. doi:10.1016/j.pain.2007.08.022
van den Beuken-van Everdingen MHJ, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18:1437–1449. doi:10.1093/annonc/mdm056
WHO (1986) Cancer pain relief. World Health Organizatin, Geneva
Wu C-L, Wang F-T, Chiang Y-C, Chiu Y-F, Lin T-G, Tsai T-L (2008) Unplanned emergency department revisits within 72 hours to a secondary teaching referral hospital in Taiwan. J Emerg Med . doi:10.1016/j.jemermed.2008.03.039
Acknowledgements
We thank Ms. Yu-Mei Tseng for reviewing the medical charts and Ms. Claire Baldwin for editing the manuscript.
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Tsai, SC., Liu, LN., Tang, ST. et al. Cancer pain as the presenting problem in emergency departments: incidence and related factors. Support Care Cancer 18, 57–65 (2010). https://doi.org/10.1007/s00520-009-0630-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-009-0630-6