Higher modified Glasgow Prognostic Score in cancer patients at the Emergency Department is associated with an increased risk of hospital admissions

BackgroundMalignancy and active systemic treatment are associated with worse outcomes in patients requiring emergency department (ED) visits. In our study, we aimed to identify cancer patients at higher risk for ED visits by examining the association of the modified Glasgow Prognostic Score with ED admissions over a three-year period.MethodsIn this retrospective analysis, we calculated the mGPS in 643 cancer patients treated with systemic therapy at the day clinic of the Division of Oncology, Medical University of Vienna from 2019 – 2021 at baseline and during the ED visit. Data on laboratory findings both at the first day of anti-cancer therapy and visit to the ED were extracted from electronic medical records.ResultsMedian patient age was 61.9 years (rage 18 – 85y). 44.5% were female and 55.5% male. Overall, the most prevalent entities were lung cancer (25%), pancreaticobiliary tumors (16%), and head and neck cancer (10%). In total, 44% had at least one visit to the ED during the observation period. ED visits led to 169 hospital admissions and a cumulative hospital stay of 1629 days. Patients with pancreaticobiliary tumors had the highest risk for unplanned ED visits, compared to those with non-pancreaticobiliary tumors (OR 1.98, 95% confidence interval (CI) [1.30,3.02]. There was no significant difference in median mGPS regarding gender or tumor entity both at baseline and in the ED. The median mGPS was significantly higher at ED visit than at baseline (Wilcoxon-signed rank test: p<0.001) and in patients requiring hospital admission (Mann-Whitney-U test: p=0.041). Baseline mGPS did not predict the risk for ED visits in our cohort. Since mGPS was evaluated only at the beginning and not during the course of treatment, a deterioration of the patient´s mGPS would go unnoticed.ConclusionsIn this retrospective analysis, a higher mGPS was observed during unplanned ED visits compared to baseline and was associated with a higher risk for hospital admission. This highlights the importance to closely monitor the mGPS in cancer patients receiving active treatment to identify those at higher risk for unplanned ED visits.Legal entity responsible for the studyClinical Division of Oncology Department of Medicine I Medical University of Vienna.FundingHas not received any funding.DisclosureA.M. Starzer: Financial Interests, Personal, Invited Speaker, Lecture honoraria: AstraZeneca; Financial Interests, Institutional, Research Grant, Industry partner of institutional Christian Doppler Laboratory: Roche; Non-Financial Interests, Member, National Oncology Society: OeGHO; Non-Financial Interests, Member, Oncology society of USA: ASCO; Other, Other, Travel support for conference participation: MSD, Lilly. M. Mair: Financial Interests, Personal, Research Funding: Bristol Myers Squibb; Financial Interests, Personal, Other: Pierre Fabre. T. Fuereder: Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme, Merck KGaA, Invios, Takeda, Pfizer, Janssen, Amgen, Roche, Boehringer Ingelheim RCV; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb, Eli Lilly, Sanofi; Financial Interests, Institutional, Funding: Merck Sharp & Dohme, Merck KGaA, Bristol Myers Squibb, Amgen, Roche. R. Bartsch: Financial Interests, Personal, Invited Speaker: AstraZeneca, Seagen, Roche, Novartis, Eli Lilly, Pierre-Fabre, Daiichi Sankyo, Gilead, MSD, Pfizer, Eisai, Gruenenthal; Financial Interests, Personal, Advisory Board: Daiichi, AstraZeneca, Roche, Novartis, Eli Lilly, Pierre Fabre, MSD, Gilead, Seagen, Eisai, Gruenenthal, Menarini; Financial Interests, Institutional, Funding, Investigator Initiated Trial: Daiichi; Financial Interests, Institutional, Coordinating PI, Drug support for investigator initiated trial: MSD. A.S. Berghoff: Financial Interests, Personal, Research Funding: Daiichi Sankyo, Roche; Financial Interests, Personal, Advisory Board: roche, Bristol Myers Squibb, Merck, Daiichi, Sankyo, AstraZeneca, CeCaVa; Financial Interests, Personal, Invited Speaker: Roche, Bristol Myers Squibb, Merck, Daiichi, Sankyo, AstraZeneca, CeCaVa; Financial Interests, Personal, Advisory Role: Roche, Bristol Myers Squibb, Merck, Daiichi, Sankyo, AstraZeneca, CeCaVa; Financial Interests, Personal, Other: Roche, Amgen, Abbvie. M. Preusser: Financial Interests, Personal, Advisory Board, and/or honoraria for lectures/consultation: Bayer, Bristol Myers Squibb, Novartis, Gerson Lehrman Group, CMC Contrast, GSK, Mundipharma, Roche, BMJ Journals, MedMedia, AstraZeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, Tocagen, Adastra, Gan & Lee Pharmaceuticals, Janssen, Servier, Miltenyi, Boehringer Ingelheim, Telix; Financial Interests, Advisory Board, and/or honoraria for lectures/consultation: Medscape. C. Minichsdorfer: Financial Interests, Personal, Advisory Role: Sandoz, Boehringer Ingelheim, MSD, Amgen; Financial Interests, Personal, Other: MSD, Merck Darmstadt. All other authors have declared no conflicts of interest.