Chapter 3 56 Referral characteristics Patients or their caregivers took the initiative to visit the ED in 34.0% for a median of 2.0 symptoms (Table 2). ED visits occurred outside office hours in 51.9%. The main symptom was new in 52.1% and acute in 36.9% of the patients and both new and acute in 29.3%. Most frequently reported main symptoms or signs were dyspnoea (21.0%), pain (18.6%), and ascites (11.9%). A total of 62.8% had an ECOG performance score of 3–4 (known in 196 of 420 patients). Table 1. 420 patients with advanced oncology visiting the emergency department Patient characteristics n (% of 420) Male 229 (54.5) Age in years, median (range) 63 (22-92) Primary tumour site Digestive tract 116 (27.6) Lung 67 (16.0) Gynaecologic 47 (11.2) Urologic 45 (10.7) Breast 37 (8.8) Head and neck 32 (7.6) Othera Time since palliative diagnosis < 3 months 143 (34.0) 3 months – 1 year 144 (34.3) 1 year – 4 years 98 (23.3) > 4 years 30 (7.1) Palliative disease phase Disease-modifying 263 (62.6) Symptom-management 157 (37.4) Treatment for primary tumour in the last 3 months Chemotherapy 168 (40.0) Hormonal therapy 28 (6.7) Targeted or immunotherapy 75 (17.9) Radiotherapy 104 (24.8) Surgery 31 (7.4) Otherb 7 (1.7) None 111 (26.4) Limitations on life-sustaining treatments Not discussed 262 (62.4) Discussed, no limitations documented 16 (3.8) Discussed, limitations documentedc 142 (33.8)
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