Abstract
Background
Patients with active cancer account for a growing percentage of all emergency department
(ED) visits and have a unique set of risks related to their disease and its treatments.
Effective triage for this population is fundamental to facilitating their emergency
care.
Objectives
We evaluated the validity of the Emergency Severity Index (ESI; version 4) triage
tool to predict ED-relevant outcomes among adult patients with active cancer.
Methods
We conducted a prespecified analysis of the observational cohort established by the
National Cancer Institute–supported Comprehensive Oncologic Emergencies Research Network’s
multicenter (18 sites) study of ED visits by patients with active cancer (N = 1075).
We used a series of χ2 tests for independence to relate ESI scores with 1) disposition, 2) ED resource use,
3) hospital length of stay, and 4) 30-day mortality.
Results
Among the 1008 subjects included in this analysis, the ESI distribution skewed heavily
toward high acuity (>95% of subjects had an ESI level of 1, 2, or 3). ESI was significantly
associated with patient disposition and ED resource use (p values < 0.05). No significant associations were observed between ESI and the non-ED
based outcomes of hospital length of stay or 30-day mortality.
Conclusion
ESI scores among ED patients with active cancer indicate higher acuity than the general
ED population and are predictive of disposition and ED resource use. These findings
show that the ESI is a valid triage tool for use in this population for outcomes directly
relevant to ED care.
Keywords
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Article info
Publication history
Published online: July 26, 2019
Accepted:
May 6,
2019
Received in revised form:
April 25,
2019
Received:
March 6,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
