肿瘤急诊科疑似癌症患者的表现和特征

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Monica K Wattana MD , Mark McIntyre MD , Adriana Wechsler MD , Patricia A. Brock MD , Faith Dupler , Sai-Ching J. Yeung MD, PhD , Aiham Qdaisat MD
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引用次数: 0

摘要

导言:由于 MD 安德森癌症中心是一家专门的肿瘤医院,因此确诊为癌症的患者是普通急诊科(ED)的常客。方法:我们在机构数据库中查询了 2020 年 11 月 1 日至 2022 年 1 月 1 日期间所有 18 岁及以上、既往无癌症诊断的急诊就诊者(使用肿瘤登记和账单数据库)。我们还对病历进行了审查,以确认确定的受试者既往没有癌症诊断,并核实他们在本机构接受了随访。我们收集了受试者的人口统计学特征、急诊室表现和临床数据。结果在研究期间,在 2727 名确认的受试者中,有 358 人符合最终资格标准。年龄中位数为 57 岁(四分位数间距:45-66 岁)。大多数患者为男性(51.1%)、白人或高加索人种(57.0%)、非西班牙裔或拉丁裔(74.0%)。几乎所有患者(99.2%)都是急诊或紧急急诊(即急诊严重程度指数分别为 2 级或 3 级)。最常见的主诉是实验室结果异常(16.8%)、高血压(9.8%)、感染和/或疑似败血症(7.5%)、恶心/呕吐(7.3%)、疲乏(7.0%)、气短(6.7%)或头痛(5.9%)。大多数患者入院治疗(59.2%)或在观察室接受治疗(18.2%)。在 212 名入院患者中,有 35 人(16.5%)在急诊室就诊后一年内死亡,明显(P=0.003)高于出院或入住观察室患者 5.5% 的一年死亡率。入院组患者的死亡率较高,原因需要进一步说明。还需要进一步研究,以了解为什么相当大一部分不需要住院的患者会在急诊室寻求治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Presentation and characteristics of patients with suspicion of cancer presenting to an oncologic emergency department

Introduction

Patients with a known cancer diagnosis are frequent visitors to general emergency departments (ED) Since MD Anderson Cancer Center is a dedicated oncologic hospital, new patients present with symptoms suspected to be attributable to a yet unconfirmed cancer diagnosis. The aim was to examine and characterize the oncologic ED presentation of new patients with a suspicion of cancer.

Methods

Our institutional database was quired for all ED visits for subjects aged 18 and older with no prior cancer diagnosis (using tumor registry and billing database) between 11/1/2020 and 01/01/2022. Chart review was conducted to confirm the absence of previous cancer diagnosis in the identified subjects and to verify they received follow-up in our institution. Demographics, ED presentation and clinical data were collected. Descriptive statistics and Chi-Square test of independence were used to analyze, compare and report the presentation and the outcomes of final eligible patients.

Results

During the study period, of the 2727 subjects identified, 358 met the final eligibility criteria. The median age was 57 years (interquartile range: 45-66 years). The majority were male (51.1%), White or Caucasian race (57.0%) and not Hispanic or Latino ethnicity (74.0%). Almost all the patients (99.2%) were presented as emergent or urgent acuity level (i.e., Emergency Severity Index levels 2 or 3 respectively). The most frequent presenting complaint(s) were: Abnormal laboratory results (16.8%); Hypertension (9.8%); infection and/or suspected sepsis (7.5%); nausea/vomiting (7.3%); fatigue (7.0%); shortness of breath (6.7%) or headache (5.9%). Most of the patients were admitted either to the hospital (59.2%) or the observation unit (18.2%). Of the 212 admitted patients, 35 (16.5%) died within one year of the ED presentation, which was significantly (P=0.003) higher than the 5.5% one-year mortality rate for the patients who were discharged or placed in the observation unit.

Conclusion

Most patients presenting to an oncologic emergency with unconfirmed suspicion of cancer require hospitalization. The admitted group have higher mortality for reasons that need further elucidation. Further research is also needed to understand why the fairly large segment that do not require hospitalization seek care in the ED setting.

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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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