
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.126
vdae090.126
Final Category: Supportive Care, Palliative Care and QOL
AcademicSubjects/MED00300
AcademicSubjects/MED00310
QSPC-11 NEWLY DIAGNOSED BRAIN METASTASES: WHAT ARE THE CRITERIA FOR EMERGENCY ROOM EVALUATION AND HOSPITAL ADMISSION?
Soto Daniel University of Virginia School of Medicine, Charlottesville, VA, USA

Wendel Sarah University of Virginia School of Medicine, Charlottesville, VA, USA

Catalino Michael University of Virginia School of Medicine, Charlottesville, VA, USA

Brady William University of Virginia School of Medicine, Charlottesville, VA, USA

Gaughan Elizabeth University of Virginia School of Medicine, Charlottesville, VA, USA

Sheehan Jason University of Virginia School of Medicine, Charlottesville, VA, USA

Fadul Camilo University of Virginia School of Medicine, Charlottesville, VA, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i38i38
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

BACKGROUND

Approximately 40% of patients with newly diagnosed brain metastases (BMETs) present to the ED or are admitted to the hospital. The optimal diagnostic and therapeutic care for these patients has not been established.

OBJECTIVE

To map and identify the opportunities to provide value care for patients who come to the ED or are admitted to the hospital with newly diagnosed BMETs.

METHODS

Following quality improvement methodology, we defined the scope of the population to be studied, developed a flowchart, and identified decision points to measure the characteristics and outcomes of patients who come to the ED or are admitted with newly diagnosed BMETs at a tertiary academic center. We abstracted data between 2017 and 2019 including performance status (ECOG, KPS, U-RPA), synchronous/metachronous status, consulting and admitting specialties, diagnostic workup performed, BMETs characteristics on imaging, and acute interventions (surgery, WBRT, and/or GKRS).

RESULTS

We identified 138/339 (40.7%) patients who met eligibility criteria; 101/138 (73.2%) presented via ED; 37/138 (26.8%) were direct admissions. Of the 138 patients, 68 (49.3%) had synchronous BMETs with 66/68 (97.1%) having tissue sampled for pathology (peripheral tissue biopsy and/or BMET surgical resection). In 83/138 (60.1%), an intervention was performed during hospital admission. The median time (h:mm) spent in the ED was 7:16 (Range: 0:58 – 25:35). Of the 101 patients seen in the ED, 96 (95.0%) were admitted. All 12 patients with hydrocephalus received an acute intervention.

CONCLUSION

The lack of clear guidelines for ED evaluation and hospital admission for patients with newly diagnosed BMETs leads to higher admission rates and inpatient resource usage. Analysis of our results will identify interventions that may improve the value of the care provided to this complex patient population.
==== Body
pmc
