Observation unit use among patients with cancer following emergency department visits: Results of a multicenter prospective cohort from CONCERN Journal Article

   

Authors:	Klotz, A. D.; Caterino, J. M.; Durham, D.; Rico, J. F.; Pallin, D. J.; Grudzen, C. R.; McNaughton, C.; Marcelin, I.; Abar, B.; Adler, D.; Bastani, A.; Bernstein, S. L.; Bischof, J. J.; Coyne, C. J.; Henning, D. J.; Hudson, M. F.; Lyman, G. H.; Madsen, T. E.; Reyes-Gibby, C. C.; Ryan, R. J.; Shapiro, N. I.; Swor, R.; Thomas, C. R. Jr; Venkat, A.; Wilson, J.; Yeung, S. C. J.; Yilmaz, S.; Stutman, R.; Baugh, C. W.
Article Title:	Observation unit use among patients with cancer following emergency department visits: Results of a multicenter prospective cohort from CONCERN
Abstract:	Purpose Emergency department (ED) visits by patients with cancer frequently end in hospitalization. As concerns about ED and hospital crowding increase, observation unit care may be an important strategy to deliver safe and efficient treatment for eligible patients. In this investigation, we compared the prevalence and clinical characteristics of cancer patients who received observation unit care with those who were admitted to the hospital from the ED. Methods We performed a multicenter prospective cohort study of patients with cancer presenting to an ED affiliated with one of 18 hospitals of the Comprehensive Oncologic Emergency Research Network (CONCERN) between March 1, 2016 and January 30, 2017. We compared patient characteristics with the prevalence of observation unit care usage, hospital admission, and length of stay. Results Of 1051 enrolled patients, 596 (56.7%) were admitted as inpatients, and 72 (6.9%) were placed in an observation unit. For patients admitted as inpatients, 23.7% had a length of stay <= 2 days. The conversion rate from observation to inpatient was 17.1% (95% CI 14.6-19.4) among those receiving care in an observation unit. The average observation unit length of stay was 14.7 h. Patient factors associated ED disposition to observation unit care were female gender and low Charlson Comorbidity Index. Conclusion In this multicenter prospective cohort study, the discrepancy between observation unit care use and short inpatient hospitalization may represent underutilization of this resource and a target for process change.
Keywords:	trial; impact; care
Journal Title:	Academic Emergency Medicine
Volume:	29
Issue:	2
ISSN:	1069-6563
Publisher:	Society for Academic Emergency Medicine
Date Published:	2022-02-01
Start Page:	174
End Page:	183
Language:	English
ACCESSION:	WOS:000726293900001
DOI:	10.1111/acem.14392
PROVIDER:	wos
PUBMED:	34811858
PMCID:	PMC10359998
Notes:	Article -- Source: Wos

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