Factors Influencing Emergency Department Visits for Pain Among Cancer Patients: A Retrospective Study
Abstract
Material and Methods: This study examined factors linked to pain-related ED visits among cancer patients at a Thai tertiary hospital. A retrospective cross-sectional study was conducted with adult cancer patients (≥18 years) who visited Songklanagarind Hospital ED between January 2010 and December 2020. Extracted data included demographic variables, cancer type, metastasis, treatment history, pain intensity, and pain medication use. Univariable and multivariable logistic regression were performed to assess the factors associated with pain-related ED visits.
Results: Among 15,144 patients, 18.8% visited the ED at least once due to pain (more commonly among younger patients and females). Pain complaints varied significantly by cancer type, with the highest rates in metastatic solid organ tumors (19.7%) and the lowest in hematopoietic and lymphoid malignancies (16.0%). Among 37,482 total ED visits, 20.2% were pain-related, which occurred more frequently during nighttime. Opioid use was linked to increased ED visits. An increased likelihood of ED visits due to pain was associated with female sex, nighttime visits, having metastatic cancer, recent chemotherapy and surgery, and prior opioid use. Conversely, older age (≥65 years) and recent radiation therapy were associated with a significantly decreased likelihood of pain-related ED visits.
Conclusion: This study highlights the potential benefits of standardized pain assessment and continuous symptom management to reduce unnecessary ED visits. A multimodal approach to pain management is essential to improve the quality of life for cancer patients.
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