Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department

Sule Yilmaz; Corita R. Grudzen; Danielle D. Durham; Caroline McNaughton; Isabelle Marcelin; Beau Abar; David Adler; Aveh Bastani; Christopher W. Baugh; Steven L. Bernstein; Jason J. Bischof; Christopher J. Coyne; Daniel J. Henning; Matthew F. Hudson; Adam Klotz; Gary H. Lyman; Troy E. Madsen; Daniel J. Pallin; Cielito Reyes-Gibby; Juan Felipe Rico; Richard J. Ryan; Nathan I. Shapiro; Robert Swor; Charles R. Thomas; Arvind Venkat; Jason Wilson; Sai Ching Jim Yeung; Jeffrey M. Caterino

doi:10.1089/jpm.2021.0567

Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department

Sule Yilmaz, Corita R. Grudzen, Danielle D. Durham, Caroline McNaughton, Isabelle Marcelin, Beau Abar, David Adler, Aveh Bastani, Christopher W. Baugh, Steven L. Bernstein, Jason J. Bischof, Christopher J. Coyne, Daniel J. Henning, Matthew F. Hudson, Adam Klotz, Gary H. Lyman, Troy E. Madsen, Daniel J. Pallin, Cielito Reyes-Gibby, Juan Felipe RicoRichard J. Ryan, Nathan I. Shapiro, Robert Swor, Charles R. Thomas, Arvind Venkat, Jason Wilson, Sai Ching Jim Yeung, Jeffrey M. Caterino

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background: Older adults with cancer use the emergency department (ED) for acute concerns. Objectives: Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. Design: A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data. Settings/Subjects: Cancer patients who presented to the 18 CONCERN affiliated EDs in the United States. Measurements: Survey included demographics, cancer type, functional status, symptom burden, palliative and hospice care enrollment, and advance directive code status. Results: Of the total (674/1075, 62.3%) patients had advanced cancer and most were White (78.6%) and female (50.3%); median age was 64 (interquartile range 54-71) years. A small proportion of them were receiving palliative (6.5% [95% confidence interval; CI 3.0-7.6]; p = 0.005) and hospice (1.3% [95% CI 1.0-3.2]; p = 0.52) care and had a higher 30-day mortality rate (8.3%, [95% CI 6.2-10.4]). Conclusions: Patients with advanced cancer continue to present to the ED despite recommendations for early delivery of palliative care.

Original language	English (US)
Pages (from-to)	1115-1121
Number of pages	7
Journal	Journal of palliative medicine
Volume	25
Issue number	7
DOIs	https://doi.org/10.1089/jpm.2021.0567
State	Published - Jul 1 2022

Keywords

advanced cancer
cohort study
oncologic emergency medicine
palliative care

ASJC Scopus subject areas

General Nursing
Anesthesiology and Pain Medicine

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10.1089/jpm.2021.0567

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Yilmaz, S., Grudzen, C. R., Durham, D. D., McNaughton, C., Marcelin, I., Abar, B., Adler, D., Bastani, A., Baugh, C. W., Bernstein, S. L., Bischof, J. J., Coyne, C. J., Henning, D. J., Hudson, M. F., Klotz, A., Lyman, G. H., Madsen, T. E., Pallin, D. J., Reyes-Gibby, C., ... Caterino, J. M. (2022). Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department. Journal of palliative medicine, 25(7), 1115-1121. https://doi.org/10.1089/jpm.2021.0567

Yilmaz, S, Grudzen, CR, Durham, DD, McNaughton, C, Marcelin, I, Abar, B, Adler, D, Bastani, A, Baugh, CW, Bernstein, SL, Bischof, JJ, Coyne, CJ, Henning, DJ, Hudson, MF, Klotz, A, Lyman, GH, Madsen, TE, Pallin, DJ, Reyes-Gibby, C, Rico, JF, Ryan, RJ, Shapiro, NI, Swor, R, Thomas, CR, Venkat, A, Wilson, J, Yeung, SCJ & Caterino, JM 2022, 'Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department', Journal of palliative medicine, vol. 25, no. 7, pp. 1115-1121. https://doi.org/10.1089/jpm.2021.0567

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title = "Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department",

abstract = "Background: Older adults with cancer use the emergency department (ED) for acute concerns. Objectives: Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. Design: A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data. Settings/Subjects: Cancer patients who presented to the 18 CONCERN affiliated EDs in the United States. Measurements: Survey included demographics, cancer type, functional status, symptom burden, palliative and hospice care enrollment, and advance directive code status. Results: Of the total (674/1075, 62.3%) patients had advanced cancer and most were White (78.6%) and female (50.3%); median age was 64 (interquartile range 54-71) years. A small proportion of them were receiving palliative (6.5% [95% confidence interval; CI 3.0-7.6]; p = 0.005) and hospice (1.3% [95% CI 1.0-3.2]; p = 0.52) care and had a higher 30-day mortality rate (8.3%, [95% CI 6.2-10.4]). Conclusions: Patients with advanced cancer continue to present to the ED despite recommendations for early delivery of palliative care.",

keywords = "advanced cancer, cohort study, oncologic emergency medicine, palliative care",

author = "Sule Yilmaz and Grudzen, {Corita R.} and Durham, {Danielle D.} and Caroline McNaughton and Isabelle Marcelin and Beau Abar and David Adler and Aveh Bastani and Baugh, {Christopher W.} and Bernstein, {Steven L.} and Bischof, {Jason J.} and Coyne, {Christopher J.} and Henning, {Daniel J.} and Hudson, {Matthew F.} and Adam Klotz and Lyman, {Gary H.} and Madsen, {Troy E.} and Pallin, {Daniel J.} and Cielito Reyes-Gibby and Rico, {Juan Felipe} and Ryan, {Richard J.} and Shapiro, {Nathan I.} and Robert Swor and Thomas, {Charles R.} and Arvind Venkat and Jason Wilson and Yeung, {Sai Ching Jim} and Caterino, {Jeffrey M.}",

year = "2022",

month = jul,

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doi = "10.1089/jpm.2021.0567",

language = "English (US)",

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T1 - Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department

AU - Yilmaz, Sule

AU - Grudzen, Corita R.

AU - Durham, Danielle D.

AU - McNaughton, Caroline

AU - Marcelin, Isabelle

AU - Abar, Beau

AU - Adler, David

AU - Bastani, Aveh

AU - Baugh, Christopher W.

AU - Bernstein, Steven L.

AU - Bischof, Jason J.

AU - Coyne, Christopher J.

AU - Henning, Daniel J.

AU - Hudson, Matthew F.

AU - Klotz, Adam

AU - Lyman, Gary H.

AU - Madsen, Troy E.

AU - Pallin, Daniel J.

AU - Reyes-Gibby, Cielito

AU - Rico, Juan Felipe

AU - Ryan, Richard J.

AU - Shapiro, Nathan I.

AU - Swor, Robert

AU - Thomas, Charles R.

AU - Venkat, Arvind

AU - Wilson, Jason

AU - Yeung, Sai Ching Jim

AU - Caterino, Jeffrey M.

PY - 2022/7/1

Y1 - 2022/7/1

N2 - Background: Older adults with cancer use the emergency department (ED) for acute concerns. Objectives: Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. Design: A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data. Settings/Subjects: Cancer patients who presented to the 18 CONCERN affiliated EDs in the United States. Measurements: Survey included demographics, cancer type, functional status, symptom burden, palliative and hospice care enrollment, and advance directive code status. Results: Of the total (674/1075, 62.3%) patients had advanced cancer and most were White (78.6%) and female (50.3%); median age was 64 (interquartile range 54-71) years. A small proportion of them were receiving palliative (6.5% [95% confidence interval; CI 3.0-7.6]; p = 0.005) and hospice (1.3% [95% CI 1.0-3.2]; p = 0.52) care and had a higher 30-day mortality rate (8.3%, [95% CI 6.2-10.4]). Conclusions: Patients with advanced cancer continue to present to the ED despite recommendations for early delivery of palliative care.

AB - Background: Older adults with cancer use the emergency department (ED) for acute concerns. Objectives: Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. Design: A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data. Settings/Subjects: Cancer patients who presented to the 18 CONCERN affiliated EDs in the United States. Measurements: Survey included demographics, cancer type, functional status, symptom burden, palliative and hospice care enrollment, and advance directive code status. Results: Of the total (674/1075, 62.3%) patients had advanced cancer and most were White (78.6%) and female (50.3%); median age was 64 (interquartile range 54-71) years. A small proportion of them were receiving palliative (6.5% [95% confidence interval; CI 3.0-7.6]; p = 0.005) and hospice (1.3% [95% CI 1.0-3.2]; p = 0.52) care and had a higher 30-day mortality rate (8.3%, [95% CI 6.2-10.4]). Conclusions: Patients with advanced cancer continue to present to the ED despite recommendations for early delivery of palliative care.

KW - advanced cancer

KW - cohort study

KW - oncologic emergency medicine

KW - palliative care

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Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department

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