Disparities in outcomes among patients diagnosed with cancer in proximity to an emergency department visit

A suspected diagnosis of cancer in the emergency department (ED) may be associated with poor outcomes, related to health disparities, however data are limited. This is a retrospective observational cohort of the Indiana State Department of Health Cancer Registry, and the Indiana Network for Patient...

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Published in:Scientific reports 2022-06, Vol.12 (1), p.10667-10667, Article 10667
Main Authors: Pettit, Nicholas, Sarmiento, Elisa, Kline, Jeffrey
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631/67/1612
631/67/2324
692/4028
Breast
Cancer
Diagnosis
Emergency medical care
Emergency medical services
Humanities and Social Sciences
Low income groups
Lung cancer
Medical diagnosis
Mortality
multidisciplinary
Prostate cancer
Regression analysis
Science
Science (multidisciplinary)
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description A suspected diagnosis of cancer in the emergency department (ED) may be associated with poor outcomes, related to health disparities, however data are limited. This is a retrospective observational cohort of the Indiana State Department of Health Cancer Registry, and the Indiana Network for Patient Care. First time cancer diagnoses appearing in the registry between January 2013 and December 2017 were included. Cases identified as patients who had an ED visit in the 6 months before their cancer diagnosis; controls had no preceding ED visits. The primary outcome was mortality, comparing ED-associated mortality to non-ED-associated. 134,761 first-time cancer patients were identified, including 15,432 (11.5%) cases. The mean age was same at 65, more of the cases were Black than the controls (12.4% vs 7.4%, P  
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Cases observed an over three-fold higher mortality, with cumulative death rate of 32.9% for cases vs 9.0% for controls ( P  &lt; .0001). Regression analysis predicting mortality, controlling for many confounders produced an odds ratio of 4.12 (95% CI 3.72–4.56 for cases). This study found that an ED visit within 6 months prior to the first time of ICD-coded cancer is associated with Black race, low income and an overall three-fold increased adjusted risk of death. The mortality rates for ED-associated cancers are uniformly worse for all cancer types. 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subjects 631/67/1612
631/67/2324
692/4028
Breast
Cancer
Diagnosis
Emergency medical care
Emergency medical services
Humanities and Social Sciences
Low income groups
Lung cancer
Medical diagnosis
Mortality
multidisciplinary
Prostate cancer
Regression analysis
Science
Science (multidisciplinary)
title Disparities in outcomes among patients diagnosed with cancer in proximity to an emergency department visit
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