Characterization of older adults with cancer seeking acute emergency department care: A prospective observational study.

Autor: Bischof JJ; Departments of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: jason.bischof@osumc.edu., Elsaid MI; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA. Electronic address: Mohamed.elsaid@osumc.edu., Bridges JFP; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA. Electronic address: John.Bridges@osumc.edu., Rosko AE; Department of Internal Medicine, Division of Hematology, Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA. Electronic address: Ashley.Rosko@osumc.edu., Presley CJ; Department of Internal Medicine, Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA. Electronic address: Carolyn.Presley@osumc.edu., Abar B; Department of Emergency Medicine, University of Rochester, Rochester, NY, USA. Electronic address: Beau_Abar@URMC.Rochester.edu., Adler D; Department of Emergency Medicine, University of Rochester, Rochester, NY, USA. Electronic address: David_Adler@URMC.Rochester.edu., Bastani A; Department of Emergency Medicine, William Beaumont Hospital - Troy Campus, Troy, MI, USA. Electronic address: Aveh.Bastani@beaumont.edu., Baugh CW; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: cbaugh@bwh.harvard.edu., Bernstein SL; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA. Electronic address: Steven.L.Bernstein@hitchcock.org., Coyne CJ; Department of Emergency Medicine, University of California San Diego, San Diego, CA, USA. Electronic address: cjcoyne@ucsd.edu., Durham DD; Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. Electronic address: danielle_durham@med.unc.edu., Grudzen CR; Ronald O. Perelman Department of Emergency Medicine and Population Health, New York University Grossman School of Medicine, New York, NY, USA. Electronic address: Corita.Grudzen@nyulangone.org., Henning DJ; Department of Emergency Medicine, University of Washington, Seattle, WA, USA. Electronic address: henning2@uw.edu., Hudson MF; Prisma Health Cancer Institute, Greenville, SC, USA. Electronic address: Matt.Hudson@prismahealth.org., Klotz A; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: klotza@MSKCC.ORG., Lyman GH; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and the Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: glyman@fredhutch.org., Madsen TE; Division of Emergency Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: Troy.Madsen@hsc.utah.edu., Reyes-Gibby CC; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: creyes@mdanderson.org., Rico JF; Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL, USA. Electronic address: jrico@health.usf.edu., Ryan RJ; Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, USA. Electronic address: richard.ryan@uc.edu., Shapiro NI; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address: nshapiro@bidmc.harvard.edu., Swor R; Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA. Electronic address: Robert.Swor@beaumont.edu., Thomas CR; Department of Radiation Oncology, Geisel School of Medicine @ Dartmouth, Lebanon, NH, USA. Electronic address: Charles.R.Thomas@Hitchcock.org., Venkat A; Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA, USA. Electronic address: Arvind.Venkat@ahn.org., Wilson J; Department of Emergency Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA., Yeung SJ; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: syeung@mdanderson.org., Yilmaz S; Department of Surgery, Division of Supportive Care in Cancer, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: Sule_Yilmaz@URMC.Rochester.edu., Caterino JM; Departments of Emergency Medicine and Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: Jeffrey.Caterino@osumc.edu.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2022 Sep; Vol. 13 (7), pp. 943-951. Date of Electronic Publication: 2022 Jun 17.
DOI: 10.1016/j.jgo.2022.06.003
Abstrakt: Introduction: Disparities in care of older adults in cancer treatment trials and emergency department (ED) use exist. This report provides a baseline description of older adults ≥65 years old who present to the ED with active cancer.
Materials and Methods: Planned secondary analysis of the Comprehensive Oncologic Emergencies Research Network observational ED cohort study sponsored by the National Cancer Institute. Of 1564 eligible adults with active cancer, 1075 patients were prospectively enrolled, of which 505 were ≥ 65 years old. We recruited this convenience sample from eighteen participating sites across the United States between February 1, 2016 and January 30, 2017.
Results: Compared to cancer patients younger than 65 years of age, older adults were more likely to be transported to the ED by emergency medical services, have a higher Charlson Comorbidity Index score, and be admitted despite no significant difference in acuity as measured by the Emergency Severity Index. Despite the higher admission rate, no significant difference was noted in hospitalization length of stay, 30-day mortality, ED revisit or hospital admission within 30 days after the index visit. Three of the top five ED diagnoses for older adults were symptom-related (fever of other and unknown origin, abdominal and pelvic pain, and pain in throat and chest). Despite this, older adults were less likely to report symptoms and less likely to receive symptomatic treatment for pain and nausea than the younger comparison group. Both younger and older adults reported a higher symptom burden on the patient reported Condensed Memorial Symptom Assessment Scale than to ED providers. When treating suspected infection, no differences were noted in regard to administration of antibiotics in the ED, admissions, or length of stay ≤2 days for those receiving ED antibiotics.
Discussion: We identified several differences between older (≥65 years old) and younger adults with active cancer seeking emergency care. Older adults frequently presented for symptom-related diagnoses but received fewer symptomatic interventions in the ED suggesting that important opportunities to improve the care of older adults with cancer in the ED exist.
Competing Interests: Declaration of Competing Interest GHL reports research Funding to institution from Amgen and support for educational programs or consulting from G1 Therapeutics; Partners Healthcare; BeyondSpring; Sandoz; Squibb; Merck; Jazz Pharm; Kallyope; TEVA; Seattle Genetics; and Samsung all outside the submitted work. SJY was a member of an expert panel for Celgene, Inc. Dr. Yeung had funding support from Bristol-Myer Squibb, Inc. and DepoMed, Inc. All other authors declare no competing financial or non-financial interests.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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