Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle East
Abstract Background Several studies emerging from developed countries have highlighted a significant number of potentially avoidable emergency department (ED) visits by cancer patients during the end-of-life period. However, there is a paucity of information from developing nations regarding palliat...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-024-01389-4 |
| _version_ | 1797272829841899520 |
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| author | Hagir Salama Mohamed H. Omer Areez Shafqat Ahmed Binahmed Ghadah Muhammed Alghamdi Mohammed Saeed Mohamed Madani Alfagi Bayan Saeed Alqahtany Feda Alshoshan Dalia Salih Ahmed Hashim Mohammad Alkaiyat Abdullah Algarni |
| author_facet | Hagir Salama Mohamed H. Omer Areez Shafqat Ahmed Binahmed Ghadah Muhammed Alghamdi Mohammed Saeed Mohamed Madani Alfagi Bayan Saeed Alqahtany Feda Alshoshan Dalia Salih Ahmed Hashim Mohammad Alkaiyat Abdullah Algarni |
| author_sort | Hagir Salama |
| collection | DOAJ |
| description | Abstract Background Several studies emerging from developed countries have highlighted a significant number of potentially avoidable emergency department (ED) visits by cancer patients during the end-of-life period. However, there is a paucity of information from developing nations regarding palliative care practices and the utilization of the ED by palliative care patients. Herein, we aim to characterize ED admissions among patients receiving palliative care at our tertiary center in Saudi Arabia. Methods This is a retrospective, cross-sectional study evaluating ED visits amongst adult patients with advanced cancer who were receiving treatment under the palliative care department. This study took place over a period of 12 months from July 2021 through to July 2022. Three palliative care specialist physicians independently and blindly reviewed each patient’s ED visits and determined whether the visit was avoidable or unavoidable. Results A total of 243 patients were included in the final analysis, of which 189 (78.1%) patients had unavoidable visits and 53 (21.9%) patient visits were classified as avoidable. A significantly higher proportion of breast cancer patients presented with unavoidable admissions (14.3% vs. 3.8%, P = 0.037) compared to other cancer types. The incidence of dyspnea (23.8% vs. 5.7%, P < 0.001) and fevers/chills (23.3% vs. 5.7%, P = 0.005) was significantly higher in patients with unavoidable visits. Patients with avoidable visits had a significantly greater proportion of visits for dehydration (13.2% vs. 2.1%, P = 0.002). Notably, although hospital stay was significantly longer in the unavoidable group (P = 0.045), mortality for palliative care patients—regardless of whether their ED visit was avoidable or unavoidable—was not statistically different (P=-0.069). Conclusion To our knowledge, this is the largest and most comprehensive study from Saudi Arabia and the Middle East providing insights into the utilization of palliative care services in the region and the propensity of advanced cancer patients towards visiting the ED. Future studies ought to explore interventions to reduce the frequency of avoidable ED visits. |
| first_indexed | 2024-03-07T14:35:11Z |
| format | Article |
| id | doaj.art-82830fb0e6964a6885b5d9ee32cc5d6e |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-03-07T14:35:11Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-82830fb0e6964a6885b5d9ee32cc5d6e2024-03-05T20:42:42ZengBMCBMC Palliative Care1472-684X2024-02-012311810.1186/s12904-024-01389-4Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle EastHagir Salama0Mohamed H. Omer1Areez Shafqat2Ahmed Binahmed3Ghadah Muhammed Alghamdi4Mohammed Saeed5Mohamed Madani Alfagi6Bayan Saeed Alqahtany7Feda Alshoshan8Dalia Salih9Ahmed Hashim10Mohammad Alkaiyat11Abdullah Algarni12Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsSchool of Medicine, Cardiff UniversityCollege of Medicine, Alfaisal UniversityDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsDepartment of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health AffairsAbstract Background Several studies emerging from developed countries have highlighted a significant number of potentially avoidable emergency department (ED) visits by cancer patients during the end-of-life period. However, there is a paucity of information from developing nations regarding palliative care practices and the utilization of the ED by palliative care patients. Herein, we aim to characterize ED admissions among patients receiving palliative care at our tertiary center in Saudi Arabia. Methods This is a retrospective, cross-sectional study evaluating ED visits amongst adult patients with advanced cancer who were receiving treatment under the palliative care department. This study took place over a period of 12 months from July 2021 through to July 2022. Three palliative care specialist physicians independently and blindly reviewed each patient’s ED visits and determined whether the visit was avoidable or unavoidable. Results A total of 243 patients were included in the final analysis, of which 189 (78.1%) patients had unavoidable visits and 53 (21.9%) patient visits were classified as avoidable. A significantly higher proportion of breast cancer patients presented with unavoidable admissions (14.3% vs. 3.8%, P = 0.037) compared to other cancer types. The incidence of dyspnea (23.8% vs. 5.7%, P < 0.001) and fevers/chills (23.3% vs. 5.7%, P = 0.005) was significantly higher in patients with unavoidable visits. Patients with avoidable visits had a significantly greater proportion of visits for dehydration (13.2% vs. 2.1%, P = 0.002). Notably, although hospital stay was significantly longer in the unavoidable group (P = 0.045), mortality for palliative care patients—regardless of whether their ED visit was avoidable or unavoidable—was not statistically different (P=-0.069). Conclusion To our knowledge, this is the largest and most comprehensive study from Saudi Arabia and the Middle East providing insights into the utilization of palliative care services in the region and the propensity of advanced cancer patients towards visiting the ED. Future studies ought to explore interventions to reduce the frequency of avoidable ED visits.https://doi.org/10.1186/s12904-024-01389-4Palliative careEnd of lifeCancerMiddle EastSaudi ArabiaEmergency department |
| spellingShingle | Hagir Salama Mohamed H. Omer Areez Shafqat Ahmed Binahmed Ghadah Muhammed Alghamdi Mohammed Saeed Mohamed Madani Alfagi Bayan Saeed Alqahtany Feda Alshoshan Dalia Salih Ahmed Hashim Mohammad Alkaiyat Abdullah Algarni Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle East BMC Palliative Care Palliative care End of life Cancer Middle East Saudi Arabia Emergency department |
| title | Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle East |
| title_full | Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle East |
| title_fullStr | Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle East |
| title_full_unstemmed | Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle East |
| title_short | Avoidable emergency department visits among palliative care cancer patients: novel insights from Saudi Arabia and the Middle East |
| title_sort | avoidable emergency department visits among palliative care cancer patients novel insights from saudi arabia and the middle east |
| topic | Palliative care End of life Cancer Middle East Saudi Arabia Emergency department |
| url | https://doi.org/10.1186/s12904-024-01389-4 |
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