Causes of Emergency Department Admission and Outcomes Among Hematologic Versus Solid Tumor Patients Admitted to a Palliative Care Unit

Background: Patients with hematologic malignancies frequently receive more aggressive end-of-life care and are less likely to receive timely palliative care than those with solid tumors.There is still little data, though, comparing the short-term outcomes of patients later admitted to inpatient palliative care units with their emergency department (ED) presentations.In this study, patients with solid tumors and those with hematologic malignancies were compared in terms of short-term clinical outcomes and the reasons for ED admission.Methods: A retrospective observational study was carried out on adult patients who were admitted straight from the ED to an inpatient palliative care unit.Patients were divided into groups for solid tumors and hematologic malignancies.Clinical, disease-related, and demographic information was taken from electronic health records.We compared the two groups' reasons for ED admission, hospital diagnoses, palliative care interventions, 30-day mortality, and 30-day readmission.To find independent predictors of 30-day mortality, multivariable logistic regression analysis was carried out.Results: Of the 256 patients, 233 (91.0%) had solid tumors, and 23 (9.0%) had hematologic malignancies.While patients with solid tumors were more likely to have metastatic disease (all p < 0.05), patients with hematologic malignancies were significantly older and more likely to be diagnosed with recurrent or relapsed disease.Regarding the reasons for ED admission, ED disposition, final hospital diagnoses, palliative procedures, 30-day mortality, and 30-day readmission, there were no discernible differences between the two groups.Malignancy type was not independently linked to a higher 30-day mortality in multivariable analysis, but increasing age and severe symptom burden at ED presentation were.Conclusions: Patients with solid tumors and hematologic malignancies had similar reasons for ED admission and similar short-term outcomes following admission to an inpatient palliative care unit, despite differences in baseline disease characteristics.Age and symptom severity were independent predictors of 30-day mortality, suggesting that clinical status at presentation may be more relevant than the type of malignancy in predicting short-term outcomes.