Triage and Length of Stay in a Cancer Center Emergency Department

Bok Hee Ha; Jeong Yun Park

doi:10.5388/aon.2017.17.4.246

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Ha and Park: Triage and Length of Stay in a Cancer Center Emergency Department

Original Article

Asian Oncol Nurs 2017;17(4):246-251.

Published online: 5 December 2017

DOI: https://doi.org/10.5388/aon.2017.17.4.246

Triage and Length of Stay in a Cancer Center Emergency Department

Bok Hee Ha¹, Jeong Yun Park²

¹Department of Nursing, National Cancer Center, Goyang, Korea

²Department of Clinical Nursing, University of Ulsan, Seoul, Korea

^∗ This article is a revision of the first author's master's thesis from Ulsan University.

Address reprint requests to: Park, Jeong Yun Department of Clinical Nursing, University of Ulsan 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5333 Fax: +82-2-3010-5332 E-mail: pjyun@ulsan.ac.kr

Received 3 Sep 201720 Sep 2017 Accepted 24 Nov 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose

The purpose of this study was to identify the triage and length of stay of cancer patients who visited an emergency department in a cancer center.

Methods

Aretrospective descriptive study design was used. Data were collected from medical records of patients who visited an emergency room from March 7 to June 30, 2016. Data were analyzed using descriptive statistics and Kruskal-Walis tests.

Results

In total, 2,699 cancer patients visited the emergency room excluding cases with insufficient records. The mean age was 58.7±18.7 years, and males were 47.0% and 56.0%, respectively. In triage, 184 (6.8%) were ‘emergency’ patients, 823 (30.5%) were ‘urgent’, and 1,692 (62.7%) were the most ‘non-emergency’ patients. The average stay of length in the emergency room was 5.79±7.69 hours.

Conclusion

These findings show that development of triage tool and communication system with staff are needed to reduce overcrowding and length of stay of the emergency department.

Keywords: Triage, Length of Stay, Neoplasms, Emergencies

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Table 1.

General Characteristics of the Subjects (N =2,699)

Variables	Categories	n (%) or M ± SD
Gender	Male	1,276(47.3)
Gender	Female	1,423(52.7)
Age (year)		58.7 ± 18.72
	＜20	57(2.1)
	20~39	199(7.4)
	40~59	1,052(39.0)
	60~79	1,253(46.4)
	＞80	138(5.1)
Diagnosis	Lung cancer	545(20.2)
	Head & neck cancer	400(14.8)
	Uterus cancer	298(11.0)
	Liver cancer	288(10.7)
	Breast cancer	269(10.0)
	Stomach cancer	219(8.1)
	Colorectum cancer	166(6.2)
	Hematologic maligancy	143(5.3)
	Brain, spinal tract cancer	135(5.0)
	Prostate cancer	104(3.8)
	Others	132(4.9)
Level of consciousness	Alert	2,628(97.4)
	Drowsy/Lethargy	47(1.7)
	Stupor	17(0.6)
	Semi-coma	4(0.2)
	Coma	3(0.1)
Chief complain	Pain	866(32.1)
	Fever, chill	403(14.9)
	Gastrointestinal symptoms	368(13.6)
	Respiratory symptoms	288(10.7)
	Bleeding	125(4.6)
	Mental status, sensory dis-turbance	118(4.4)
	General weakness, dizzi-ness	94(3.5)
	Whole body rash, itching	72(2.7)
	urinary symptoms	22(0.8)
	Others	343(12.7)

Table 2.

Visit Characteristics of the Subjects (N =2,699)

Variables	Categories	n (%) or M ± SD
Visit method	Walking	2,382(88.3)
Visit method	Ambulance	317(11.7)
Visit type	Self	2,086(77.3)
	Referral (outpatient department)	335(12.4)
	Referral (another hospital)	278(10.3)
Visit time	Day (06:00~13:59)	1,252(46.5)
	Evening (14:00~21:59)	1,052(38.8)
	Night (22:00~05:59)	395(14.7)
Visit day of week	Weekday	2,138(79.3)
Visit day of week	Weekend	561(20.7)
Decision result	Discharge	1,728(64.0)
Decision result	Admission	971(36.0)
Length of stay (hrs)		5.79 ± 7.69
	＜3	918(34.0)
	3~67~12	927586(34.4)(21.7)
	13~24	202(7.5)
	＞24	66(2.4)

Table 3.

Triage of the Subjects (N =2,699)

Variables		n (%)
Emergency		184(6.8)
	Severe chest pain (NRS 7~10)	27(1.0)
	Anaphylaxis	26(1.0)
	Systolic blood pressure＜80 mmHg	22(0.8)
	Heart rate＜40 bpm or＞150 bpm	20(0.7)
	Hyperthermia or hypothermia related sepsis	18(0.7)
	Seizure	9(0.3)
	Altered mentality	5(0.2)
	Saturation＜80% with dyspnea	1(0.0)
	Other	56(2.1)
Urgency		823 (30.5)
	Pain (NRS 4~6)	459(17.0)
	Fever related chemotherapy	126 (4.7)
	Emerging neurological symptoms	95(3.5)
	Saturation＜90% with dyspnea	69(2.6)
	Severe bleeding in main organ	61(2.3)
	Bleeding following major trauma	2(0.1)
	Closed fracture	2(0.1)
	Urgency other	9(0.3)

Non emergency 1,692 (62.7)

Table 4.

Length of Stay of the Subjects (N =2,699)

Variables	Categories	Length of stay (hrs)
Variables	Categories	M ± SD	x²	p
Triage	Emergency	7.08 ± 8.05	53.17	＜.001
	Urgency	6.59 ± 6.44
	Non-emergency	5.26 ± 8.16
Visit time	Day (06:00~13:59)	5.39 ± 8.55	107.05	＜.001
	Evening (14:00~21:59)	5.65 ± 7.17
	Night (22:00~05:59)	7.44 ± 5.72
Visit day of week	weekday	6.02 ± 8.25	19.97	＜.001
Visit day of week	Weekend	4.93 ± 4.95
Clinical symptom: emergency of triage (n=184)	Hyperthermia/hypothermia related sepsis	8.09 ± 8.19	28.22	＜.001
	Systolic blood pressure＜80 mmHg	7.90 ± 7.11
	Severe chest pain (NRS 7~10)	7.79 ± 10.45
	Heart rate＜40 bpm or＞50 bpm	7.16 ± 8.24
	Seizure	6.96 ± 4.98
	Altered mentality	4.85 ± 3.43
	Anaphylaxis	2.31 ± 1.47
	Others	8.37 ± 8.95
Clinical symptom: urgency of triage (n=823)	Bleeding following major trauma	16.40 ± 0.13	11.97	.101
	Emerging neurological symptoms	7.80 ± 6.59
	Closed fracture	7.27 ± 5.81
	Severe bleeding in main organ	7.26 ± 7.86
	Saturation＜90% with dyspnea	6.79 ± 8.01
	Fever related chemotherapy	6.40 ± 6.70
	Pain (NRS 4~6)	6.30 ± 5.91
	Urgency other	5.80 ± 8.09

NRS= Numerical rating scale; bpm= beats per minute.

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