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.