Jae Hoon Lee, Sang Yun Jung, Ki Ho Yu, Mee Hee Shin, Yun Jung Choi, Ra Mi Choi, Woo Jin Seo, Sang Hee Park, Won Ho Han
Abstract
Patients with cancer who develop acute abdomen are at high risk of rapid clinical deterioration and often require emergency surgery and intensive care. This retrospective cohort study evaluated the impact of implementing a Rapid Response System (RRS) on survival among 274 patients admitted for emergency surgery at a tertiary cancer center in Korea (145 pre-RRS, 129 post-RRS).
Introduction
Each year >18 million new cancer cases are diagnosed worldwide. A significant portion of patients require inpatient care due to complications related to their immunocompromised state. Over half of emergency department visits by cancer patients result in hospitalization, compared to 11.9% for non-cancer patients, highlighting the need for close monitoring in healthcare settings [1,2].
Materials and methods
This retrospective single-center study was conducted at the National Cancer Center (NCC), Republic of Korea, and included adult cancer patients (aged ≥18 years) who developed acute abdomen during hospitalization and required emergency surgery with ICU admission.
Results
Among the 424 patients initially assessed for eligibility, 150 were excluded: 62 patients presented with acute abdominal cases between 11:00 PM and 6:00 AM, 52 patients did not require ICU admission due to mild severity.
Discussion
This study is the first to investigate the impact of the RRS on patients requiring emergency surgery for acute abdomen, providing valuable insights into the utility of the RRS for this high-risk group. The improved survival observed during the RRS period suggests that such systems can enhance patient outcomes by enabling timely interventions.
Conclusions
Improved survival after RRS implementation appears to be associated with more timely perioperative care and attenuated postoperative organ dysfunction, suggesting that RRS activation may help stabilize high-risk surgical patients.
Citation: Lee JH, Jung SY, Yu KH, Shin MH, Choi YJ, Choi RM, et al. (2026) Evaluating the impact of a rapid response system on survival of patients with cancer undergoing emergency surgery for acute abdomen: A single-center retrospective cohort study. PLoS One 21(1): e0341616. https://doi.org/10.1371/journal.pone.0341616
Editor: Stefano Turi, IRCCS: IRCCS Ospedale San Raffaele, ITALY
Received: March 27, 2025; Accepted: January 11, 2026; Published: January 30, 2026
Copyright: © 2026 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The data underlying this study contain sensitive and potentially identifiable patient information and cannot be made publicly available due to ethical and legal restrictions imposed by the Institutional Review Board of the National Cancer Center, Korea. De-identified data may be made available to qualified researchers upon reasonable request and approval from the Institutional Review Board. Requests for data access should be directed to the IRB office ([email protected]).
Funding: Initials of the authors who received each award: WHH Grant numbers awarded to each author: NCC 2310790-3 The full name of each funder: National Cancer Center, Korea URL of each funder website: https://www.ncc.re.kr/indexEn.ncc The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
