Retrospective review of patients with lung cancer identified in the emergency department

Pettit, Nicholas; Cinbat, Melisa

doi:10.1016/j.ajem.2021.08.040

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…The studies found that 12–32% of cancer diagnoses occurred through the ED. 14 , 41 Cancer diagnosis pathways varied by cancer type; for example, lung cancers diagnosed through an ED ranged from 10 to 57% 14 , 42 , 43 , 44 , 45 , 46 while colorectal cancer diagnosed through an ED ranged from 15 to 42% 14 , 47 , 48 , 49 (Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

Diagnosis of cancer in the Emergency Department: A scoping review

et al. 2023

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Background The Emergency Department (ED) plays a key role in the identification and care of acute medical conditions, including cancer. In this scoping review, we aimed to determine the role of the ED in the acute diagnosis of cancer. Methods We conducted a scoping review of articles according to Preferred Reporting Items for Systematic Review and Meta‐Analyses (PRISMA) using PubMed and Google Scholar. We screened studies of adults with a new diagnosis of cancer in the ED. We included randomized control trials, prospective, retrospective, and cross‐sectional observational studies, and case reports published in English since 2000. We grouped the articles into categories based on their objectives and findings. Results Of the 4459 articles, we included 47 in the review. The identified studies fell into three major categories: (1) studies describing the incidental diagnosis of cancer in the ED (n = 11, 23%), (2) studies characterizing the acute initial presentation of cancer in the ED (n = 19, 41%), and (3) studies describing the ED as a pathway to cancer diagnosis in the healthcare system (n = 17, 36%). Across the studies, cancer diagnoses in the ED were more likely in patients with higher comorbidities, occurred at later stages, and resulted in worse survival rates. Conclusions The ED plays a prominent role in the initial diagnosis of cancer. Efforts must be made to integrate the ED within the cancer care continuum.

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Section: Resultsmentioning

confidence: 99%

Diagnosis of cancer in the Emergency Department: A scoping review

et al. 2023

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“…These findings contrast with literature showing a lack of establishment with a PCP as a risk factor for an ED-related cancer diagnosis. 13 , 25 , 26 , 27 , 28 A study reviewing ED-related cervical cancer diagnosis in a Dallas safety net hospital showed 194 (78.8%) of 246 patients with incident cervical cancer following a previous ED visit were not previously established with the hospital system. 13 The discrepancy in these results may be because of Mayo Clinic’s primary function as a tertiary care facility focused on subspecialty care, in contrast to current literature that predominantly explores safety net hospital systems focused on care for those with fewer resources.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department Visits Before Cancer Diagnosis Among Women at Mayo Clinic

Stauder,

Borkar,

Glasgow

et al. 2024

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…4 When people present to the ED with life threatening manifestations of their undiagnosed cancer they are more likely advanced stages and are less likely to be curative. 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

“…Prior work from the United Kingdom's “Routes‐to‐Diagnosis” work suggested that 23% of newly diagnosed cancer patients presented emergently and survival rates were much lower for emergent presenters 4 . When people present to the ED with life threatening manifestations of their undiagnosed cancer they are more likely advanced stages and are less likely to be curative 5,6 …”

Section: Introductionmentioning

confidence: 99%

“…4 When people present to the ED with life threatening manifestations of their undiagnosed cancer they are more likely advanced stages and are less likely to be curative. 5,6 Safety-net hospital systems, including safety-net EDs, disproportionately serve vulnerable patient populations. 7 Safety-net hospitals generally treat greater percentages of racial/ethnic minorities, Medicaid and uninsured patients, patients from communities in the lowest income quartile, and provide large amounts of uncompensated care.…”

Section: Introductionmentioning

confidence: 99%

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Worsened outcomes of newly diagnosed cancer in patients with recent emergency care visits: A retrospective cohort study of 3699 adults in a safety net health system

Pettit

Stewart

et al. 2022

Cancer Medicine

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Introduction: Many patients receive a suspected diagnosis of cancer through an emergency department (ED) visit. Time to treatment for a new diagnosis of cancer is directly associated with improved outcomes with little no describing the ED utilization prior to the diagnosis of cancer. We hypothesize that patients that have an ED visit in proximity to a diagnosis of cancer will have worse outcomes, including mortality.Methods: This study is a retrospective cohort study of all patients with cancer diagnosed at Eskenazi Health (Indiana) between 2016 and 2019. Individual health characteristics, ED utilization, cancer types, and mortality were studied. We compared those patients seen in the ED within 6 months prior to their diagnosis (cases) to patients not seen in the ED (controls).Results: A total of 3699 patients with cancer were included, with 1239 cases (33.50%). Patients of black race had higher frequencies in the cases vs. controls (46.57% vs. 40.68%). Lung cancer was the most frequently observed cancer among cases vs. controls (11.70% vs. 5.57%). For the cases, 232 patients were deceased (18.72%) compared with 247 patients among the controls (10.04%, p < 0.0001, OR 2.06 95% confidence interval [CI] 1. 70-2.51). An ED visit in past 6 months (OR = 1.73, 95% CI 1.38-2.18) and Medicaid insurance type (versus commercial, OR = 4.16, 95% CI 2.45-7.07) were associated with of mortality. Female gender (OR = 0.76, 95% CI 0.67-0.88), tobacco use (OR = 1.62, 95% CI 138-1.90), and Medicaid insurance type (versus commercial, OR = 2.56, 95% CI 2.07-3.47) were associated with prior ED use. Conclusions:Over one third of patients with cancer were seen in the ED within 6 months prior to their cancer diagnosis. Higher mortality rates were observed for those seen in the ED. Future studies are needed to investigate the association and impact that the ED has on eventual cancer diagnoses and outcomes.

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Retrospective review of patients with lung cancer identified in the emergency department

Cited by 6 publications

References 15 publications

Diagnosis of cancer in the Emergency Department: A scoping review

Diagnosis of cancer in the Emergency Department: A scoping review

Emergency Department Visits Before Cancer Diagnosis Among Women at Mayo Clinic

Worsened outcomes of newly diagnosed cancer in patients with recent emergency care visits: A retrospective cohort study of 3699 adults in a safety net health system

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