Subtle oncological emergencies: Nature of illness, clinical characteristics, and outcomes

The primary objective was to assess whether presentation severity at the emergency department (ED) can determine treatment and health outcomes among patients with oncological emergencies.

We conducted a three-year retrospective analysis of accessible records of adult cancer patients admitted with oncological emergencies.

Patients with subtle presentations had longer wait times than patients with severe presentations in all ED timeliness indicators. On average, subtle presentations were significantly associated with 47.5 min increase in time to be seen, 33 min increase in time to be treated, 42 min increase in time to decide on admission and prolonged ED stay by 24 min (p < 0.05). Subtle presentations were also significantly associated with a four-fold increase in intensive care unit admissions and a three-fold increase in mortality odds.

The severity of the clinical presentations significantly predicted oncological emergencies' treatment and health outcomes. This research raises the importance of emergency triage decision accuracy. Triage health workers should have a solid knowledge base regarding oncological emergencies to improve patients' early recognition and prioritization. Oncological emergency presentations can be subtle, rendering patients vulnerable extensive delay and inferior outcomes. Therefore, triage nurses should be educated and trained on the multiple available severity scales sensitive to identifying the real urgency. Also, protocols and care pathways should be in place to enable immediate fast-tracking of patients and the provision of timely treatment.