title: Should Vital Signs Be Routinely Obtained Prior to Intravenous Chemotherapy? Results From a 2-Center Study.
abstract: BACKGROUND
  The American Society of Clinical Oncology and the Oncology Nursing Society have issued guidelines stating that the vital signs of patients should be routinely checked on days that intravenous chemotherapy is administered. This study sought evidence to justify this approach.
  
  
  METHODS
  This trial focused on consecutive patients with cancer from 2 institutions and evaluated outcomes during the first cycle of gemcitabine-based chemotherapy. The primary end point of the study was a visit to the ED, hospitalization, or death during the first cycle of chemotherapy.
  
  
  RESULTS
  Medical records from 1,158 patients were reviewed, and vital signs were checked in 589 patients on day 1 and in 486 on day 8. A total of 148 patients (12.8%) were evaluated in the emergency department (ED), 145 (12.5%) were hospitalized, and 11 (0.9%) died during their first cycle of chemotherapy. In multivariate analyses, which were adjusted for age, sex, cancer type, role of chemotherapy, number of chemotherapy drugs administered on day 1, and institution, checking vital signs on day 1 was associated with neither higher rates of ED visits nor with increased hospitalization; however, checking vital signs on day 8 was associated with higher rates of ED visits (odds ratio [OR]: 3.71; 95% confidence interval [CI]: 2.18-6.22; P < .0001) and higher rates of hospitalizations (OR: 3.98; 95% CI: 2.34-6.73; P < .0001).
  
  
  CONCLUSIONS
  This study suggests a need for additional, evidence-based data to support the routine checking of vital signs prior to administering cancer chemotherapy.
authors.affiliation: Mayo Clinic, Rochester, MN. Jatoi.Aminah@mayo.edu.
authors.forename: Smitha
authors.initials: S
authors.lastname: Menon
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Foster
authors.forename: Sherry
authors.initials: S
authors.lastname: Looker
authors.forename: Kristine
authors.initials: K
authors.lastname: Sorgatz
authors.forename: Pashtoon Murtaza
authors.initials: PM
authors.lastname: Kasi
authors.forename: Robert R
authors.initials: RR
authors.lastname: McWilliams
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
mesh_terms: D061605:Administration, Intravenous / Q000379:methods; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000188:drug therapy*; D055986:Vital Signs / Q000502:physiology*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents