Treatment Outcome of Patients with Gynaecological Cancer Presenting to Emergency Department of A Tertiary Care Hospital

Author(s): Kumari S

Introduction: Patients with Gynaecological malignancies frequently visit the Emergency Department (ED). Knowledge of clinical presentation and their acute management will help in delivering a better care to these patients.

Materials and Methods: A Cross sectional study was conducted in the ED of All India Institute of Medical Sciences New Delhi, India from January 1, 2018 to December 31, 2018. The study cohort comprised of fifty patients with gynaecological cancer. Inpatient medical record was evaluated.

Results: Median age of fifty patients was 45.5 years (range 18 - 68). Carcinoma cervix was the most common malignancy (28 cases, 56%) followed by carcinoma ovary (14 cases, 28%), carcinoma endometrium (3 cases, 6%), gestational trophoblastic neoplasia (3 cases, 6%), molar pregnancy (1 case, 2%) and leiomyosarcoma (1 case, 2%). Predominant complaints were pain (28%), anuria (22%), bleeding per vaginum (22%) and shortness of breath (14%). Obstructive uropathy was the most common diagnosis (26%) followed by anaemia (18%), electrolyte imbalance (14%) and intestinal obstruction (14%). Bilateral percutaneous nephrostomy and electrolyte correction were the commonest intervention in 12 cases each (24%) followed by antifibrinolytics in 11 cases (22%), pain management in 10 cases (20%) hemodialysis in 9 cases (18%), blood transfusion in 8 cases (16%). Median length of hospital stay was 48 hours (6 – 96 hours). Six patients underwent emergency laparotomy. Of fifty patients two (4%) expired during the stay.

Conclusion: Pain was the commonest presentation and appropriately managing pain is a significant contributor to improving quality of life in these patients.