{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:04:59Z","timestamp":1760151899728,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Pain remains an undertreated complication of cancer, with poor pain control decreasing patients\u2019 quality of life. Traditionally, patients presenting to an emergency department with pain have only had two dispositions available to them: hospitalization or discharge. A third emerging healthcare environment, the emergency department observation unit (EDOU), affords patients access to a hospital\u2019s resources without hospitalization. To define the role of an EDOU in the management of cancer pain, we conducted a retrospective study analyzing patients placed in an EDOU with uncontrolled cancer pain for one year. Patient characteristics were summarized using descriptive statistics and predictors of disposition from the EDOU and were identified with univariate and multivariate analyses. Most patients were discharged home, and discharged patients had low 72-hour revisit and 30-day mortality rates. Significant predictors of hospitalization were initial EDOU pain score (odds ratio (OR) = 1.12; 95% CI 1.06\u20131.19; p &lt; 0.001) and supportive care (OR = 2.04; 95% CI 1.37\u20133.04; p &lt; 0.001) or pain service (OR = 2.67; 95% CI 1.63\u20134.40; p &lt; 0.001) consultations. We concluded that an EDOU appears to be the appropriate venue to care for a subsegment of patients presenting to an emergency department with cancer pain, with patients receiving safe care as well as appropriate consultation and admission when indicated.<\/jats:p>","DOI":"10.3390\/cancers14235871","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T02:09:58Z","timestamp":1669687798000},"page":"5871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and Outcomes of Patients with Cancer Pain Placed in an Emergency Department Observation Unit"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3589-1902","authenticated-orcid":false,"given":"Pavitra Parimala","family":"Krishnamani","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"},{"name":"Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0063-8461","authenticated-orcid":false,"given":"Aiham","family":"Qdaisat","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica Kathleen","family":"Wattana","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2037-3085","authenticated-orcid":false,"given":"Demis N.","family":"Lipe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"},{"name":"IQVIA Biotech, Morrisville, NC 27560, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9655-2461","authenticated-orcid":false,"given":"Marcelo","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Elsayem","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Cruz Carreras","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5170-0822","authenticated-orcid":false,"given":"Sai-Ching Jim","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5914-6712","authenticated-orcid":false,"given":"Patrick S.","family":"Chaftari","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1002\/1097-0142(19890201)63:3<593::AID-CNCR2820630332>3.0.CO;2-5","article-title":"Pain experience and pain management among hospitalized cancer patients. A clinical study","volume":"63","author":"Dorrepaal","year":"1989","journal-title":"Cancer"},{"key":"ref_2","first-page":"381","article-title":"Current approach to cancer pain management: Availability and implications of different treatment options","volume":"3","author":"Nersesyan","year":"2007","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/s11912-022-01245-9","article-title":"The Value Proposition of Observation Medicine in Managing Acute Oncologic Pain","volume":"24","author":"Krishnamani","year":"2022","journal-title":"Curr. Oncol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e190979","DOI":"10.1001\/jamanetworkopen.2019.0979","article-title":"Analysis of Diagnoses, Symptoms, Medications, and Admissions Among Patients with Cancer Presenting to Emergency Departments","volume":"2","author":"Caterino","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4543","DOI":"10.1007\/s00520-021-05987-3","article-title":"Cancer pain management in the emergency department: A multicenter prospective observational trial of the Comprehensive Oncologic Emergencies Research Network (CONCERN)","volume":"29","author":"Coyne","year":"2021","journal-title":"Support Care Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.jpainsymman.2017.07.013","article-title":"Evaluation of Emergency Department Management of Opioid-Tolerant Cancer Patients with Acute Pain","volume":"54","author":"Patel","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1038\/sj.bjc.6605053","article-title":"Pattern and quality of care of cancer pain management. Results from the Cancer Pain Outcome Research Study Group","volume":"100","author":"Apolone","year":"2009","journal-title":"Br. J. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3879","DOI":"10.1200\/JCO.2007.15.9517","article-title":"Evidence-Based Standards for Cancer Pain Management","volume":"26","author":"Dy","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1177\/107327480000700202","article-title":"Cancer Pain Management","volume":"7","author":"Cleary","year":"2000","journal-title":"Cancer Control"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1097\/00045391-200211000-00007","article-title":"Patterns of use of an emergency department-based observation unit","volume":"9","author":"Hostetler","year":"2002","journal-title":"Am. J. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1067\/mem.2003.153","article-title":"The use and effectiveness of an emergency department observation unit for elderly patients","volume":"41","author":"Ross","year":"2003","journal-title":"Ann. Emerg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.annemergmed.2010.02.012","article-title":"The Recidivism Characteristics of an Emergency Department Observation Unit","volume":"56","author":"Ross","year":"2009","journal-title":"Ann. Emerg. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e574","DOI":"10.1200\/OP.21.00478","article-title":"Outcomes of patients placed in an emergency department observation unit of a comprehensive cancer center","volume":"18","author":"Chaftari","year":"2021","journal-title":"JCO Oncol. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.currproblcancer.2018.05.002","article-title":"Factors associated with optimal pain management in advanced cancer patients","volume":"43","author":"Wang","year":"2019","journal-title":"Curr. Probl. Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.pain.2011.12.005","article-title":"Which domains should be included in a cancer pain classification system? Analyses of longitudinal data","volume":"153","author":"Knudsen","year":"2012","journal-title":"Pain"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2896","DOI":"10.1016\/j.ejca.2010.04.017","article-title":"An international multicentre validation study of a pain classification system for cancer patients","volume":"46","author":"Fainsinger","year":"2010","journal-title":"Eur. J. Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1054\/jpai.2002.27136","article-title":"A survey of pain-related hospitalizations, emergency department visits, and physician office visits reported by cancer patients with and without history of breakthrough pain","volume":"3","author":"Fortner","year":"2002","journal-title":"J. Pain"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1200\/JCO.19.01963","article-title":"Trends in the Cost of Cancer Care: Beyond Drugs","volume":"38","author":"Laviana","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40138-013-0038-y","article-title":"Observation Units: Definition, History, Data, Financial Considerations, and Metrics","volume":"2","author":"Napolitano","year":"2014","journal-title":"Curr. Emerg. Hosp. Med. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2314","DOI":"10.1377\/hlthaff.2011.0926","article-title":"Making Greater Use of Dedicated Hospital Observation Units For Many Short-Stay Patients Could Save $3.1 Billion A Year","volume":"31","author":"Baugh","year":"2012","journal-title":"Health Aff."},{"key":"ref_21","first-page":"415","article-title":"Management of health-care\u2013associated infections in the oncology patient","volume":"17","author":"Guinan","year":"2003","journal-title":"Oncology"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/5871\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:28:56Z","timestamp":1760146136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/5871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,29]]},"references-count":21,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["cancers14235871"],"URL":"https:\/\/doi.org\/10.3390\/cancers14235871","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2022,11,29]]}}}