Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System.

IF 2.9 3区医学 Q1 OTORHINOLARYNGOLOGY

Clinical and Experimental Otorhinolaryngology Pub Date : 2025-02-01 Epub Date: 2024-12-02 DOI:10.21053/ceo.2024.00257

Heejun Yi, Hyojun Kim, Younghac Kim, Ye-Jin Suh, Joo Hyun Park, Nayeon Choi, Han-Sin Jeong

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引用次数: 0

Abstract

Objectives: A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.

Methods: This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.

Results: The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1-4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2-4, 8.6%-12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.

Conclusion: The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.

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头颈癌患者急诊室就诊的危险因素：韩国医疗保健系统的纵向队列研究

目的：由于多种治疗方式的应用，相当比例的头颈癌（HNC）患者在治疗期间或治疗后出现一次或多次急诊室（ER）就诊或计划外住院。我们调查了癌症治疗后访问急诊室的HNC病例，以确定韩国医疗保健系统背景下的潜在危险因素。方法：这是一项单中心队列研究，研究对象是2019年在ooo接受癌症治疗的HNC患者（N = 566）。患者分别接受单纯手术治疗（184例）、手术加辅助治疗（138例）、根治性非手术治疗（放疗或放化疗）（209例）或姑息治疗（35例）。我们对癌症治疗后（或治疗期间）就诊的患者进行了长达3年的随访，并分析了就诊的主要原因和危险因素。结果：15例HNC患者急诊就诊率为8.0% （N = 45）。（N = 70, 12.4%，均值= 1.56，范围= 1-4），其中与治疗相关的ER就诊占4.6%。就诊的常见原因是手术部位或伤口问题（每名患者31.1%，每次就诊22.9%），以及口腔摄入或喂养问题（每名患者22.2%，每次就诊31.4%）。肿瘤亚位点（下咽癌治疗相关ER就诊的17.9%）、肿瘤负担（T2-4患者为8.6-12.2%，N+患者为6.7%）和治疗方式（手术加辅助化疗放疗，19.4%）被确定为ER就诊的重要危险因素，而患者年龄和合并症则不是。结论：HNC患者就诊最常见的原因是伤口和喂养问题，肿瘤因素和治疗方式是就诊的独立危险因素。解决这些问题的适当计划和管理可以帮助减少急诊室就诊和费用，并改善患者护理。

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

Clinical and Experimental Otorhinolaryngology 医学-耳鼻喉科学

CiteScore

4.90

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.