The use of red flags during the referral chain of patients surgically treated for symptomatic spinal metastases.

IF 2.4 Q2 CLINICAL NEUROLOGY
Floris R van Tol, Isabelle M L P Kamm, Anne L Versteeg, Karijn P M Suijkerbuijk, Helena M Verkooijen, Cumher Oner, Jorrit-Jan Verlaan
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引用次数: 1

Abstract

Background: The use of so-called "red flags" may be beneficial in identifying patients with metastatic spinal disease. This study examined the utility and efficacy of these red flags in the referral chain of patients surgically treated for spinal metastases.

Methods: The referral chains from the onset of symptoms until surgical treatment for all patients receiving surgery for spinal metastases between March 2009 and December 2020 were reconstructed. The documentation of red flags, as defined by the Dutch National Guideline on Metastatic Spinal Disease, was assessed for each healthcare provider involved.

Results: A total of 389 patients were included in the study. On average, 33.3% of red flags were documented as present, 3.6% were documented as absent, and 63.1% were undocumented. A higher rate of red flags documented as present was associated with a longer time to diagnosis, but a shorter time to definitive treatment by a spine surgeon. Moreover, red flags were documented as present more often in patients who developed neurological symptoms at any point during the referral chain than those who remained neurologically intact.

Conclusions: The association of red flags with developing neurological deficits highlights their significance in clinical assessment. However, the presence of red flags was not found to decrease delays prior to referral to a spine surgeon, indicating that their relevance is currently not sufficiently recognized by healthcare providers. Raising awareness of symptoms indicative of spinal metastases may expedite timely (surgical) treatment and thus improve treatment outcome.

Abstract Image

在有症状的脊柱转移手术治疗的患者转诊链中使用红旗。
背景:使用所谓的“危险信号”可能有助于识别转移性脊柱疾病患者。本研究考察了这些危险信号在脊柱转移手术患者转诊链中的效用和疗效。方法:重建2009年3月至2020年12月间所有脊柱转移手术患者从症状出现到手术治疗的转诊链。根据荷兰国家转移性脊柱疾病指南的定义,对涉及的每个医疗保健提供者进行了评估。结果:共纳入389例患者。平均而言,33.3%的危险信号被记录为存在,3.6%被记录为不存在,63.1%被记录为没有记录。记录在案的危险信号率越高,诊断时间越长,但脊柱外科医生最终治疗的时间越短。此外,在转诊过程中出现神经系统症状的患者比神经系统完好的患者更常出现危险信号。结论:危险信号与发展中的神经功能缺陷的关联突出了它们在临床评估中的重要性。然而,在转诊给脊柱外科医生之前,发现危险信号的存在并没有减少延误,这表明它们的相关性目前没有得到医疗保健提供者的充分认识。提高对脊柱转移症状的认识可以加快及时(手术)治疗,从而改善治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neuro-oncology practice
Neuro-oncology practice CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
11.10%
发文量
92
期刊介绍: Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
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