La consultation médicale en urgence dans le parcours du patient en oncologie

Abstract

Medical emergencies are defined at the medical level, whereas the use of emergency consultations is decided by the patient. Urgent oncology cares are specific due to clinical, therapeutic, technic and psychologic complexity. This descriptive retrospective study about 142consultations carried out at the unplanned medical unit, with an analyse of demographics, clinical characteristics, reason for medical appeal, deployed resources and oncological pathway for six months. Breast (48%) and lung (21%) cancer are the most common. 68% of patients present with a disease at a non-curative stage and 83% have received a cancer treatment within the previous two months. Pain is the main reason for consultation (19). 91% of patients benefit from diagnostic and therapeutic procedures. At three month, half of patients use an emergency system again. At six months, the tumour progression rate is 54%. The mortality rate is 33% regardless of the risk of immediate aggravation. The use of emergency consultation mainly concerns patients in a palliative situation, sometimes announcing the change of the trajectory towards the advanced phase. The organization of the emergency care pathway should evolve to better consider the needs of this population, by formalizing longitudinal monitoring, collaboration with palliative care teams and coordination with care providers in the city.