title: Unplanned oncology admissions within 14 days of non-surgical discharge: a retrospective study.
abstract: OBJECTIVE
  The aim of this study was to identify the incidence, causes, risk factors and interventions for cancer patients requiring unplanned admissions within 14 days of discharge at a large metropolitan private hospital without a co-located emergency department.
  
  
  METHODS
  Retrospective data were collected on cancer patients who had an unplanned admission within 14 days of discharge during the period December 1, 2011 and May 31, 2012. Data were collected from the inpatient bed administration database and medical record review. Variables collected included demographics, cancer diagnosis, reasons for admission, interventions, and length of stay.
  
  
  RESULTS
  A total of 133 oncology patients required 206 unplanned admissions (UPAs). The most common cancer diagnoses associated with unplanned readmission were upper gastrointestinal (25.4%), colorectal (19.6%), gynaecological (18.8%) and breast (13.8%) cancers. The symptoms most commonly associated with unplanned re-admission were pain (16%); infection not associated with neutropaenia (15.5%); fever and febrile neutropaenia (14.6%); nausea, vomiting and dehydration (13.6%); dyspnoea (8.3%) and altered neurological status (7.8%). The median length of stay (LOS) was 6 days. Length of stay during UPA was decreased for patients with a partner and for those who had a palliative care consult. The need for psychological supports was related to a longer LOS during UPA.
  
  
  CONCLUSIONS
  Cancer patients are at a significant risk of requiring unscheduled care and admission. Strategies and services to limit the burden on patients and the health care system should be reviewed to minimise the incidence of unplanned admission.
authors.affiliation: Solaris Care Centre, St John of God Hospital, 12 Salvado Rd., Subiaco, WA, 6008, Australia. Samantha.Gibson@sjog.org.au.
authors.forename: Samantha
authors.identifier: http://orcid.org/0000-0001-6592-6267
authors.initials: S
authors.lastname: Gibson
authors.affiliation: School of Nursing and Midwifery, Curtin University, GPO U 1987, Perth, WA, 6845, Australia.
authors.forename: Ruth
authors.initials: R
authors.lastname: McConigley
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003695:Delivery of Health Care; D004636:Emergency Service, Hospital; D005260:Female; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014904:Western Australia
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; Chemotherapy; Emergencies; Oncology; Toxicities; Unplanned admissions