Abstract 4378: Risk factors for death in the emergency department for melanoma patients

Abstract

Abstract Introduction: Many cancer deaths are related to melanoma. While there have been many studies that have identified risk factors for death in these patients, very few of them have analyzed the risk factors for death in melanoma patients in the emergency department (ED). Methods: We utilized the 2006-2012 Nationwide Emergency Department Sample to characterize melanoma patients who die in the ED. Multivariate logistic regression was used to identify patient and hospital characteristics that were significantly associated with a higher chance of death. A p-value ≤0.05 was considered significant. Results: From 2006 to 2012, 239,956 melanoma patients presented to the ED, and 2.1% of these melanoma patients died. Most melanoma patients who died in the ED were over the age of 70 years (60.0%), male (63.8%), Medicare beneficiaries (65.6%), of the highest income quartile (31.0%), presenting to a hospital in the South (35.3%), presenting to non-trauma hospitals (48.3%), and presenting to metropolitan non-teaching hospitals (43.4%). The most common reasons for patients who died upon presentation to the ED were a secondary malignancy (20.7%), septicemia (10.8%), acute cerebrovascular disease (7.5%), pneumonia (5.2%), and congestive heart failure (2.6%). The top 3 factors associated with high risk of death were septicemia (odds ratio (OR)=7.39, 95% confidence interval (CI)=5.79-9.43; p<0.001), acute cerebrovascular disease (OR=3.44, 95%CI=2.62-4.51; p<0.001), and age >70 years (OR=2.50, 95%CI=1.24-5.03; p=0.010). Table 1 lists all risk factors associated with a higher risk of death. Conclusion: Melanoma patients over the age of 70, with septicemia, acute cerebrovascular disease, or pneumonia, and of male sex are at higher risk for death in the ED. Clinicians should be aware of these risk factors when melanoma patients present to the ED. Risk Factors Associated with Death for Melanoma Patients in the Emergency Department Risk Factor Odds Ratio (95% Confidence Interval) p-value Septicemia 7.39 (5.79-9.43) <0.001 Acute Cerebrovascular Disease 3.44 (2.62-4.51) <0.001 Age >70 2.50 (1.24-5.03) 0.010 Charlson Comorbidity Index of 3 or More 2.32 (1.89-2.84) <0.001 Pneumonia 1.76 (1.27-2.45) 0.001 Charlson Comorbidity Index of 1 1.64 (1.40-1.93) <0.001 Charlson Comorbidity Index of 2 1.63 (1.31-2.03) <0.001 Medicaid 1.63 (1.19-2.23) 0.002 Metropolitan Teaching Hospital 1.33 (1.05-1.68) 0.017 Citation Format: Jayla Hsiung, Kamil Taneja, Karan Patel, Michael Diaz, Jared Wolfe, Eric M. Toloza. Risk factors for death in the emergency department for melanoma patients. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4378.