17530 Background: The prognosis of patients (pts) with advanced cancers that are newly diagnosed during hospital admission is unclear. A better understanding of their outcomes can streamline management and facilitate referrals to specialists. Our aims were to evaluate the likelihood of hospital discharge and receipt of outpatient palliative systemic therapy (ST) in this group of pts and examine clinical factors associated with treatment. Methods: Pts who were admitted to a medical or surgical ward from 2004 to 2007 and assessed by the medical oncology inpatient consultation service for de novo stage IV lung or gastrointestinal (GI) cancers were reviewed. Logistic regression analyses were performed to determine pt demographics, disease characteristics and baseline admission laboratory investigations that predicted for subsequent assessment in an outpatient medical oncology clinic (OMOC) and treatment with ST. Results: Of the 139 eligible pts, 80 (58%) were male, 58 (42%) had lung cancer and 86 (62%) were admitted to a medical ward. The median age was 66.6 years (range 19 to 93). Dyspnea and abdominal discomfort were the most common hospital presenting complaints from lung and GI cancer pts, respectively. Median time from admission to first medical oncology consultation and median duration of hospital stay was 1.4 and 2.9 weeks, respectively. In 52 (37%) cases, pts successfully proceeded to hospital discharge. Within this cohort, median interval from discharge to OMOC assessment was 3.2 weeks. In multivariate analysis, pts with low hemoglobin and high AST levels were less likely to be seen in the OMOC for ST (OR 0.13 p=0.02 and OR 0.03 p=0.01, respectively). Other demographical features and disease parameters failed to predict for prognosis (all p>0.05). Conclusions: More than one-third of inpatients diagnosed with advanced cancers are discharged from hospital and given outpatient palliative ST, but time from discharge to first outpatient assessment is long. Conversely, close to two-thirds of inpatients never receive outpatient ST for their advanced diseases suggesting that admission to hospital at the time of initial diagnosis is a poor prognostic factor. In the subset of individuals with evidence of anemia and liver dysfunction on admission, early palliative care referral may be beneficial. No significant financial relationships to disclose.