Anxiety in patients with cancer and emergency department use: a systematic review.
Hong-Ying Chung, Kalki Nagaratnam, Chris Walsh et al.
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In 30 seconds
This systematic review examined whether anxiety is associated with subsequent emergency department (ED) use among adults with cancer. Seven retrospective studies, spanning single-centre, multicentre and population-based designs, were included; differences in populations, anxiety measures, outcome timing and analyses precluded meta-analysis. Findings were mixed: four studies found no statistically significant association in adjusted analyses, while three reported a significant positive association, with effect estimates ranging from 1.23 to 3.87. Where significant associations were observed, anxiety was linked to greater ED use.
Key findings
- Four of seven studies found no statistically significant adjusted association between anxiety and ED use; three reported a significant positive association.
- In studies reporting significant associations, effect estimates ranged from 1.23 to 3.87.
- The review did not perform a meta-analysis because of substantial heterogeneity across studies.
Why it matters
Anxiety may be relevant to patterns of acute care use among adults with cancer, but the available evidence does not establish a consistent association. Recognizing this uncertainty can help frame assessment of ED use without assuming anxiety is its cause. More comparable research is needed to clarify whether, when and in which cancer populations anxiety relates to subsequent ED visits.
What to keep in mind
The evidence came from seven retrospective studies with substantial heterogeneity in cancer populations, anxiety measurement, outcome timing, ED definitions and analytic approaches; no meta-analysis was possible.