Background Cancer patients are characterised by a high frequency of attendance at the emergency services. Specialised care is required due to complications from chemotherapy treatments. It is important that patients are educated about what to expect from their regimen and the correct use of supportive care medications.
Purpose To identify, quantify and analyse the reasons why cancer patients come to the emergency service, and to evaluate the toxicities related to chemotherapy.
Material and methods Observational and retrospective study including patients who attended in an emergency during 2014 and required the assistance of the oncologist. Data were collected from the PCH emergency programme and clinical documentation. Data analysed: age, sex, stage, histology, hospitalisation required, mean duration of hospitalisation and time between the last cycle of chemotherapy and the day attended the emergency service. The reasons for assistance were grouped into three types: tumour cause, chemotherapy toxicity and other.
Results 238 emergency events were analysed in 158 patients with a mean age of 65 ± 12.3 years. 58.2% (92) were men and 77.8% (123) were in stage IV. Regarding tumour histology, the majority were colorectal in 22.7% (36) of patients, and breast and lung in 20.8% (33). 50.8% (121) of events required hospitalisation with a mean duration of 11.4 days (1–24). The tumour cause was the reason for attendance by the oncologist in 47.4% (113) of events (including asthenia and dyspnoea). Chemotherapy toxicity was the reason in 36.9% (88) of cases. Of these, 47 were haematological disorders (15 with grade IV anaemia and 9 with grade IV neutropenia), 37 gastrointestinal disorders and 7 neurological disorders. The mean number of days between the last cycle of chemotherapy and the day attended the emergency service was 8.2 (1–24). 15.5% (37) of events were due to other reasons.
Conclusion The main reason why cancer patients come to the emergency service is related to the tumour process itself, followed by post-chemotherapy toxicities in 36.9% of events (mainly haematologic and gastrointestinal disorders). Pharmacists can educate patients about the adverse effects of chemotherapy and the ability to manage them. It would be interesting to develop models to predict the risk of post-chemotherapy toxicities in order to reduce these toxicities (and hospitalisations).
No conflict of interest.
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