Emergency department utilization among skin cancer patients: a retrospective study of the national emergency department sample 2013-2015.

Abstract

Skin cancer-related emergency department (ED) visits are among the most common cancer-related ED visits in the USA. However, ED utilization among skin cancer patients has not been evaluated. To assess overall utilization of EDs among skin cancer patients, reasons for skin cancer-related visits, and factors associated with inpatient admission. This was a retrospective, cross-sectional study of adults with skin cancer presenting to EDs using years 2013-2015 of the Nationwide Emergency Department Sample. In total, 693,835 of the 223,329,909 weighted ED visits were made by patients with skin cancer. Visits among this population were frequently due to age-related comorbidities and skin cancer treatment-specific adverse events. Melanoma accounted for the minority of skin cancer-related visits (27.58%), but over half of subsequent inpatient admissions (51.18%) and was associated with greater odds of inpatient admission compared to keratinocyte carcinoma (OR 1.278, 95% CI 1.264-1.293). Treatment and staging codes were not available, and thus, differences in ED utilization among skin cancer stages and treatment approaches could not be assessed. Ultimately, these findings are important in improving anticipatory outpatient care for patients with skin cancer and in guiding appropriate management of this unique population in the ED.