Comparing Wait Times and Outcomes in Adult Oncology Patients with Febrile Neutropenia in the Emergency Department: A Retrospective Analysis

Abstract

Due to the rapidly increasing elderly population and to the advancements in oncology, there has been an increase in the diagnosis of cancer, and also a rise in oncologic emergencies. Chemotherapy and immunotherapy are increasingly being used in people with advanced cancer to palliate symptoms and improve survival and quality of life. However, research found that over 50% of patients receiving outpatient chemotherapy will have an ED visit, presenting with greater clinical complexity, higher admission rates and have higher morbidity and mortality at that admission. Furthermore, the side effects experienced from the cancer itself or its’ treatment can be life threatening if not addressed adequately. Research findings indicate that the acute care, non-specialized environment of an emergency department (ED) is not conducive for providing complex care to a patient with cancer who is in need of an immediate intervention for an acute issue. The objective of the retrospective chart review was to compare patient outcomes in regards to wait time for adult oncology patients age 50-89 with neutropenic fever in the emergency department. The RE-AIM model has been selected to guide this project proposal. A retrospective chart review was performed in order to measure outcomes for febrile neutropenic patients such as hospital length of stay, sepsis and mortality. Results yielded a significant relationship between age and time to antibiotic (TTA) but not for TTA and increased length of stay, increased incidence of sepsis or increase in mortality. More research is needed to address symptom management in an acute care setting in this specialized population.