Identifying the reasons for the Emergency Department (ED) visit of patients with cancer would be essential for possibly decreasing the burden of ED use. The aim of our study was to analyze the distribution of the demographic and clinical parameters of patients with cancer based on the reasons for the ED visits and to identify possible predictive factors for their visits. This retrospective study, carried out at a large, public tertiary hospital in Hungary, involved all patients 18 years or over, who had received a cancer diagnosis latest within five years of their visit to the ED in 2018. Demographic and clinical characteristics were collected partly via automated data collection and partly through the manual chart review by a team of experts, including six emergency physicians and an oncologist. Five main reasons for the ED visit were hypothesized, pilot-tested, then identified, including those with cancer-related ED visits (whose visit was unambiguously related to their cancer illness) and those with non-cancer-related ED visits (whose visit to the ED was in no way associated with their cancer illness.) A descriptive approach was used for data analysis and binary logistic regression was used to determine predictive factors for patients with cancer visiting the ED. 23.2% of the altogether 2383 ED visits were directly cancer-related, and these patients had a significantly worse overall survival than patients with non-cancer related ED visits. Age 65 or below (Odds Ratio: 1.51), presence of two more comorbidities (OR: 7.14), dyspnea as chief complaint (OR: 1.52), respiratory cancer (OR: 3.37), any prior chemotherapy (OR: 1.8), any prior immune/biological treatment (OR: 2.21), any prior Best Supportive Care/palliative care (OR: 19.06), or any prior hospice care (OR: 9.43), and hospitalization (OR:2.88) were independent risk factors for the ED visit to be cancer-related. Our study is the first to identify independent predictive factors of ED use by patients with cancer based on the chief cause of their visit in the Central and Eastern European region. These results may provide important information for the development of algorithms intended to identify the needs of care of patients with cancer at the ED.

中文翻译：

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匈牙利某三级医疗中心癌症相关急诊就诊的主要原因及预测因素

确定癌症患者到急诊科 (ED) 就诊的原因对于可能减轻急诊科使用负担至关重要。我们研究的目的是根据就诊的原因分析癌症患者的人口统计学和临床​​参数的分布，并确定他们就诊的可能预测因素。这项回顾性研究在匈牙利的一家大型公立三级医院进行，涉及所有 18 岁或以上的患者，这些患者最近在 2018 年就诊 ED 后的五年内接受了癌症诊断。部分收集了人口统计学和临床​​特征通过自动数据收集，部分通过专家团队的人工图表审查，包括六名急诊医师和一名肿瘤学家。对 ED 就诊的五个主要原因进行了假设、试点测试，然后确定，包括那些与癌症相关的 ED 就诊（其就诊与他们的癌症疾病明确相关）和那些与癌症无关的 ED 就诊（其就诊ED 与他们的癌症疾病没有任何关系。）使用描述性方法进行数据分析，并使用二元逻辑回归来确定癌症患者就诊 ED 的预测因素。在总共 2383 次急诊就诊中，有 23.2% 与癌症直接相关，这些患者的总生存期明显低于非癌症相关急诊就诊的患者。65 岁或以下（优势比：1.51），存在两种以上的合并症（OR：7.14），以呼吸困难为主诉（OR：1.52），呼吸道癌（OR：3.37），任何先前的化疗（OR：1.8），任何先前的免疫/生物治疗（OR：2.21），任何先前的最佳支持治疗/姑息治疗（OR：19.06）或任何先前的临终关怀（OR：9.43）和住院治疗（OR：2.88）是独立的风险因素急诊科就诊与癌症有关。我们的研究首次根据癌症患者在中欧和东欧地区就诊的主要原因确定了他们使用 ED 的独立预测因素。这些结果可能为开发旨在确定 ED 癌症患者护理需求的算法提供重要信息。我们的研究首次根据癌症患者在中欧和东欧地区就诊的主要原因确定了他们使用 ED 的独立预测因素。这些结果可能为开发旨在确定 ED 癌症患者护理需求的算法提供重要信息。我们的研究首次根据癌症患者在中欧和东欧地区就诊的主要原因确定了他们使用 ED 的独立预测因素。这些结果可能为开发旨在确定 ED 癌症患者护理需求的算法提供重要信息。