REAL-LIFE DATA FROM AN ONCOLOGY INFIRMARY IN A BRAZILIAN UNIVERSITY-BASED TEACHING HOSPITAL

Introduction: Oncological patients are mostly treated in ambulatorial scenarios but may demand complex in-hospital care. At our university-teaching hospital, we conduct 15.000 ambulatory consults yearly. Objectives: Analyze data regarding patients in need of hospital care admitted in our Oncology infirmary aiming better clinical practices, clinical support and scope for financial and structural needs for institutions. Method: A prospective study of 190 patients admitted for in-hospital care during a year who were stratified by diagnosis, age, sex, admission reason, duration of stay, re-admission rate and outcomes. Results: 97 male and 93 female patients were admitted, with a 61-year-old mean age; mean stay was 13,4 days; and re-admission rate of 9,47%. Main admission causes: Terminality [Defined by PS-ECOG = 4, with a 30 day or less estimated life expectancy]:30 patients (15,71%); total pain: 23 (12,04%); oncological emergencies [Febrile neutropenia, malignant hypercalcemia, medullar compression, superior vena cava syndrome]: 20 (10,47%); clinical deterioration [defined as worsening of patients performance or malnutrition]: 15 (7,85%); abdominal pain [without acute abdomen]: 14 (7,33%). Most common primary tumor sites were: colorectal = 30 (15,71%), breast = 28 (14,66%), stomach = 20 (10,47%), lung = 14 (7,33%), ovary = 12 (6,28%) and prostate = 10 (5,24%). Outcomes: 99 deaths (mortality rate 52,11%). Patients in terminality presented 90% ratio of mortality within an average of 6,6 days of hospital care. Febrile neutropenia (42,80%) and abdominal pain (35,70%) both achieved above expected mortality rates. 91 patients were discharged from hospital and went back to ambulatory care. Conclusions: Admission rate of 1,26%, pointing at good clinical ambulatorial practices. The mean inhospital stay comparison between patients who were discharged and those who died, not considered terminal ill, was unexpectedly similar, 11,78 versus 13,44 days, respectively, suggesting that in-hospital care should be focused on symptoms not outcomes. Patients with febrile neutropenia and gastrointestinal cancer should be evaluated with caution due to higher than expected mortality rates.