Predictive factors of basic palliative and hospice care among patients with cancer visiting the emergency department in a Hungarian tertiary care center

Csaba Varga; Zsolt Springó; Márton Koch; Lilla Prenek; Lili Porcsa; Szabolcs Bellyei; László Rumi; Éva Szabó; Zoltan Ungvari; Kyra Girán; István Kiss; Éva Pozsgai

doi:10.1016/j.heliyon.2024.e29348

Predictive factors of basic palliative and hospice care among patients with cancer visiting the emergency department in a Hungarian tertiary care center

Heliyon. 2024 Apr 6;10(8):e29348. doi: 10.1016/j.heliyon.2024.e29348. eCollection 2024 Apr 30.

Authors

Csaba Varga^{1

2}, Zsolt Springó^{3

4}, Márton Koch¹, Lilla Prenek¹, Lili Porcsa¹, Szabolcs Bellyei⁵, László Rumi⁶, Éva Szabó⁷, Zoltan Ungvari^{4

8

9}, Kyra Girán¹⁰, István Kiss³, Éva Pozsgai^{3

11}

Affiliations

¹ Department of Emergency Medicine, Somogy County Kaposi Mór General Hospital, 7400 Kaposvár, Tallián Gyula Street 20-32, Hungary.
² Department of Emergency Medicine, Semmelweis University, 1082 Budapest Üllői Street 78/A, Hungary.
³ Department of Public Health Medicine, University of Pécs Medical School, 7624 Pécs, Szigeti Street 12, Hungary.
⁴ International Training Program in Geroscience/Healthy Aging Program, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary.
⁵ Department of Oncotherapy, University of Pécs Clinical Center, 7624 Pécs, Édesanyák Street 17, Hungary.
⁶ Urology Clinic, Clinical Center, University of Pécs, 7621, Munkácsy Mihaly Street 2, Hungary.
⁷ Department of Otorhinolaryngology, University of Pécs Clinical Center, 7621 Pécs, Munkácsy M. Street 2., Hungary.
⁸ Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
⁹ Department of Health Promotion Sciences, The Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
¹⁰ Faculty of Social and Behavioural Sciences, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands.
¹¹ Department of Primary Health Care, University of Pécs Medical School, 7623 Hungary Pécs, Rákóczi Street 2, Hungary.

Abstract

Introduction: Patients with advanced cancer tend to utilize the services of the health care system, particularly emergency departments (EDs), more often, however EDs aren't necessarily the most ideal environments for providing care to these patients. The objective of our study was to analyze the clinical and demographic characteristics of advanced patients with cancer receiving basic palliative care (BPC) or hospice care (HC), and to identify predictive factors of BPC and HC prior to their visit to the ED, in a large tertiary care center in Hungary.

Methods: A retrospective, detailed analysis of patients receiving only BPC or HC, out of 1512 patients with cancer visiting the ED in 2018, was carried out. Sociodemographic and clinical data were collected via automated and manual chart review. Patients were followed up to determine length of survival. Descriptive and exploratory statistical analyses were performed.

Results: Hospital admission, multiple (≥4x) ED visits, and respiratory cancer were independent risk factors for receiving only BPC (OR: 3.10, CI: 1.90-5.04; OR: 2.97, CI: 1.50-5.84; OR: 1.82, CI: 1.03-3.22, respectively), or HC (OR: 2.15, CI: 1.26-3.67; OR: 4.94, CI: 2.51-9.71; OR: 2.07, CI: 1.10-3.91). Visiting the ED only once was found to be a negative predictive factor for BPC (OR: 0.28, CI: 0.18-0.45) and HC (OR: 0.18, 0.10-0.31) among patients with cancer visiting the ED.

Conclusions: Our study is the first from this European region to provide information regarding the characteristics of patients with cancer receiving BPC and HC who visited the ED, as well as to identify possible predictive factors of receiving BPC and HC. Our study may have relevant implications for health care planning strategies in practice.

Keywords: Advanced patients with cancer; Cancer; Emergency department; Emergency department visit; Hospice care; Hospitalization; Palliative care; Predictive factor.