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Patients with cancer and hospital admissions: disease trajectory and strategic choices
  1. Gianmauro Numico1,
  2. Rachele Ferrua1,
  3. Elena Fea1,
  4. Jacopo Giamello2,
  5. Ida Colantonio1,
  6. Marcella Occelli1,
  7. Anna Maria Vandone1,
  8. Paola Vanella1,
  9. Giacomo Aimar1,
  10. Chiara Pisano1,
  11. Elena Parlagreco1,
  12. Irene Persano1,
  13. Michela Milanesio1 and
  14. Roberto Ippoliti3
  1. 1Medical Oncology, AO S.Croce e Carle, Cuneo, Italy
  2. 2Emergency Medicine, AO S.Croce e Carle, Cuneo, Italy
  3. 3Department of Jurisprudence and Political Economic and Social Sciences, University of Eastern Piedmont Amedeo Avogadro, Alessandria, Piemonte, Italy
  1. Correspondence to Dr Gianmauro Numico, Medical Oncology, AO S.Croce e Carle, Cuneo 12100, Italy; numico.g{at}


Objectives Hospital admission (HA) in cancer history is a common, repeated and frequently unplanned event. The emergency departments (EDs) and the oncological outpatient service (OOS) are the ordinary way of entry. We studied the reasons of admission, pathways of access and discharge and prognostic factors in a population of admitted patients with cancer.

Methods The health records of the admitted patients in the oncological ward of a referral hospital in a 6-month period were retrieved and analysed. The characteristics of those admitted in the last 3 months of life were compared with the other group.

Results Among the 147 HA, 79.5% were unplanned, 48.9% passing through the ED and 30.6% through the OOS; 56.5% were due to cancer-related symptoms; 50.3% occurred in the last 3 months of life. Median overall survival was 90 days (95% IC 53.1–126.9). Independent prognostic factors for survival were: being admitted for symptoms, referral through the ED and not being discharged at home.

Conclusions Hospital is a turning point in the cancer care pathway. Patients needing HA have a dismal prognosis, half of them being in the last 3 months of life. This group can be identified using universally available variables.

  • cancer
  • hospital care
  • prognosis
  • end of life care
  • symptoms and symptom management

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  • Contributors GN, RF and EF contributed to planning, conduct and reporting. JG contributed to data interpretation and reporting. IC, MO, AMV, PV, GA, CP, EP, IP and MM contributed to conduct, data entry and data interpretation. RI contributed to statistical analysis, data interpretation and reporting.

  • Funding The work was part of a quality improvement effort of the Department of Medical Oncology.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.