Publication: Acil servise başvuran kanser hastalarının klinik karakteristikleri ve bir yıllık sağkalımları
Abstract
Çalışmanın amacı, acil servise başvuran kanser hastalarının özelliklerinin tanımlanması, yeni tanı kanser olgularının analiz edilmesi ve bir yıllık sağkalımın belirlenmesidir. Üniversite Hastanesi acil servisine bir yıllık zaman diliminde başvuran, malign neoplastik hastalık koduyla kaydedilen yetişkin hastalar, geriye dönük değerlendirildi. Hastaların demografik bilgileri, geliş yakınmaları, bulguları ve sağkalım bilgileri; hastane ve diğer ilgili resmi kayıtlardan ve telefon görüşmeleriyle toplandı. Örneklemi oluşturan 174 hastadan 29'u acil serviste yeni tanı aldı. Başvuruların %83.4'ü onkoloji ilgiliydi. Acil serviste yeni tanı alan 29 hastanın en sık başvuru nedenleri ağrı (%48) ve dispneydi (%13). Her iki grupta da en sık tutulum akciğerdi. İleri evre kanserler çoğunluğu oluşturuyordu. Bu grup, lokalize kanserli hastalara göre 12.69 kez, bölgesel kanserli olgular ise lokalize kanserlilere göre 7.12 kez daha fazla onkoloji ilgili başvuruda bulunmuştur. Onkoloji ilgili başvuruda bulunan hastaların %83'ü bir yıl içinde ölmüştür. Onkoloji ilgili başvurusu olanların, erkeklerin, uzak evre kanserli olguların bir yıllık sağkalım süreleri daha kısadır. Kanser olguları acil servise sıklıkla ileri evre hastalığa bağlı ağrı ve dispne nedeniyle başvurmaktadır. Acil tıp hekimleri kanser olgularının sık başvuru nedenlerinin yönetimi için ilgili disiplinlerle ortaklaştırılmış protokolleri izlemelidir.
The objective is to define the characteristics of cancer patients in the Emergency Departments (ED), and determination of one-year survival. A retrospective survey of the patients referred to our University-based ED in one year diagnosed with neoplasm was conducted. Patient information regarding demographics, chief complaints, findings and survival were gathered from hospital registry, health administration and by telephone survey. The sample comprised 174 patients of whom, 29 had received the diagnosis in the ED. 83.4% of these visits were oncology-related. The most common complaint of 29 newly diagnosed patients in the ED were pain (48%), dyspnoea (13%). Lungs were the most commonly involved organ. The majority of the patients harbored advanced disease. Cases in the distant stage were 12.69 times more likely to report oncology-related symptoms (ORS) than cases with localized cancer and cases with regional cancer were 7.12 times more likely than localized cases. 83% of patients with ORS died within one year. Male patients, those with ORS, and distant stage had significantly shorter survival. Cancer patients are referred to ED due to pain and dyspnoea resulting from advanced disease. Emergency physicians should have protocols shared with the relevant disciplines as to the management of commonly encountered problems of cancer patients.
The objective is to define the characteristics of cancer patients in the Emergency Departments (ED), and determination of one-year survival. A retrospective survey of the patients referred to our University-based ED in one year diagnosed with neoplasm was conducted. Patient information regarding demographics, chief complaints, findings and survival were gathered from hospital registry, health administration and by telephone survey. The sample comprised 174 patients of whom, 29 had received the diagnosis in the ED. 83.4% of these visits were oncology-related. The most common complaint of 29 newly diagnosed patients in the ED were pain (48%), dyspnoea (13%). Lungs were the most commonly involved organ. The majority of the patients harbored advanced disease. Cases in the distant stage were 12.69 times more likely to report oncology-related symptoms (ORS) than cases with localized cancer and cases with regional cancer were 7.12 times more likely than localized cases. 83% of patients with ORS died within one year. Male patients, those with ORS, and distant stage had significantly shorter survival. Cancer patients are referred to ED due to pain and dyspnoea resulting from advanced disease. Emergency physicians should have protocols shared with the relevant disciplines as to the management of commonly encountered problems of cancer patients.