1613P - Acute Oncology Service and Reduction of Inpatient Length of Stay for Cancer Patients. A report for 846 Patients Admitted with Oncological Emergencies

Abstract

ABSTRACT Background The Acute Oncology Service (AOS) has been recommended in the UK since 2008, when the National Chemotherapy Advisory Group (NCAG), and the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) reported the results of safety and quality in systemic therapy for cancer patients. The National Patient Safety agency (NPSA) recommended that cancer related emergencies be dealt in a systematic approach. This abstract refers to the data from patients with known or undiagnosed cancer, admitted in Musgrove Park Hospital (MPH) and referred to the AOS. Materials and method We collected the data of patients admitted to MPH because of cancer or treatment-induced complications or undiagnosed cancer. Patients were referred via the inpatient referral system and were registered daily in a purpose built database. We recorded patients' demographics, diagnosis, metastatic sites, treatment type, reason of admission and length of in-hospital stay (LOS). Results From June 2010 to April 2012, 846 patients were admitted with oncological complications. 48% had multiple metastatic sites, 18% had primary diagnosis of breast cancer, 19% urological, 16% lung, 24% upper and lower GI cancers and 5% of unknown primary. Only 1% of patients were referred from A&E department, 28% from medical assessment unit and 71% from the medical wards. 29% of patients were admitted during their chemotherapy period, 8% during their radiotherapy treatment, whereas for 38%, the type of treatment was not reported. The reasons of admission were: Dyspnoea 14%, Neutropenic sepsis 8%, CNS related 9%, metastatic spinal cord compression 6%, pain 12%, miscellaneous/unclear 51%. Admission was attributed to cancer and/or treatment in 73% of patients and it was unclear/unknown in 23%. The number of referrals has increased from 50 for the first 2 months to 97, the last 2 months. The LOS ranged from 0-102 days and the median remained stable at 10 days. Conclusion The majority of cancer patients with complications are admitted in medical wards. This real time audit will be used to re-define the appropriate AOS model. Further education, communication, recourses and training are mandatory to reduce the patients' LOS and develop a cost-efficient service. Disclosure All authors have declared no conflicts of interest.