According to reports, cancer patients admitted to the ICU later have a worse prognosis. For a study, researchers compared cancer patients’ 180-day survival rates after being hospitalized either directly from the emergency department (ED) or indirectly from the wards following an ED visit.
Adult cancer patients who attended the ED in 2018 and were admitted to the ICU at any time within 7 days of the ED visit were included in the retrospective observational analysis. After adjusting for baseline variables, Kaplan-Meier curves were used to illustrate survival at day 180. The hazard ratio (HR) using Cox proportional-hazard models was then used to assess the relationship between admission modality (straight from the ED or later from wards) & survival at day 180.
A total of 4,560 patients were admitted to the hospital after visiting the ED during the research period, of whom 136 (3%) had cancer and were sent to the intensive care unit (ICU), either directly from the ED in 101 (74%) instances or indirectly from the wards in 35 (26%) cases. Compared to those admitted primarily from wards, patients admitted to the ICU through the ED had a superior 180-day survival (log-rank P=0.006). Survival at day 180 was substantially enhanced in cases of admission to the ICU straight from the ED, with an adjusted HR of 0.50 (95% CI, 0.26-0.95), P=0.03 after adjustment for disease state (remission or uncontrolled malignancy).
In contrast to patients who had a delayed ICU admission secondary from the wards, ED patients with cancer who were admitted directly to the ICU had a greater 180-day survival rate. However, a number of confounders were overlooked, which restricted the applicability of the finding.
