Chief Complaints, Clinical Characteristics, and Outcomes of Emergency Department Visit among Pediatric Cancer Patients: A Single-Center Experience Chief Complaint of ED Visits among Ped Cancer Patients
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Abstract
OBJECTIVE: The aim of this study was to examine the chief complaints and clinical characteristics, outcomes, and associated factors of pediatric cancer patients who present at the emergency department (ED).
METHODS: A retrospective, single-center study was conducted on children less than 18 years old with active cancer treatment at the Department of Pediatrics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand from January 2017 to September 2023. The chief complaints, and clinical characteristics of ED encounter were captured. The outcomes of the patients were categorized into those from admitted patients and those from the discharged group, before the potential risk factors were analyzed.
RESULTS: A total of 91 ED encounters were documented among fifty cancer patients, representing 0.2% of total pediatric ED visits. Sixty-three (69.2%) ED visits met the inclusion criteria. The most common cancer was acute lymphoblastic leukemia. The common ED chief complaints were fever, gastrointestinal complaints, and respiratory complaints. Our results show that most pediatric cancer patients presenting at the ED were hospitalized (84.1%). There were no deaths at ED, and no patient died within 48 hours of ED visits. Seventy-seven percent of patients sought care within one day of developing emergency conditions. Fever as a chief complaint (p = 0.016), and levels 1 and 2 of emergency severity index (ESI) were the risk factors associated with cancer ED visits resulting in hospitalization (odds ratio = 5.64; 95% confidence intervals 1.09-29.14).
CONCLUSION: ED visits were common among children with cancer. The most frequent chief complaints were fever, gastrointestinal complaints, and respiratory complaints. Approximately 80% of ED visits resulted in hospitalization. Having fever as the chief compliant, especially in patients with high body temperature, and levels 1 and 2 of ESI, were associated with an increased likelihood of admission. This study provides valuable baseline information to enhanced the quality of emergency care for pediatric cancer patients.
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