School of Nursing, Queen's University, 92 Barrie Street, Kingston, ON, Canada.
Support Care Cancer. 2012 Aug;20(8):1589-99. doi: 10.1007/s00520-012-1459-y. Epub 2012 Apr 17.
The aim of this review was to explore the range and prevalence of cancer treatment or disease-related symptoms in the emergency department and their associated outcomes.
A systematic review examined studies cited in Medline, Embase, PsycINFO, and CINAHL published from 1980 to July 2011. Eligible studies measured emergency department visits for symptom assessment in adult oncology patients. Two reviewers independently screened citations and double data extraction was used. Descriptive analysis was conducted.
Of 1,298 citations, six prospective and 12 retrospective descriptive studies were included. Of these, eight focused on multiple symptoms and 10 targeted specific symptoms. The studies were published between 1995 and 2011, conducted in seven countries, and had a median sample size of 143 (range 9-27,644). Of the 28 symptoms reported, the most common were febrile neutropenia, infection, pain, fever, and dyspnea. Definitions provided for individual symptoms were inconsistent. Of 16 studies reporting admission rates, emergency visits resulted in hospital admissions 58 % (median) of the time in multi-symptom studies (range 31 % to 100 %) and 100 % (median) of the time in targeted symptoms studies (range 39 % to 100 %). Of 11 studies reporting mortality rates, 13 % (median) of emergency visits captured in multi-symptom studies (range 1 % to 56 %) and 20 % (median) of visits in targeted symptoms studies (range 4 % to 67 %) resulted in death.
Individuals with cancer present to emergency departments with a myriad of symptoms. Over half of emergency department visits resulted in hospital admissions. Few symptoms were defined adequately to compare data across studies, thereby revealing an important gap in cancer symptom reporting.
本综述旨在探讨急诊科癌症治疗或疾病相关症状的范围和流行率及其相关结局。
系统综述查阅了 Medline、Embase、PsycINFO 和 CINAHL 自 1980 年至 2011 年 7 月收录的文献。纳入研究测量了成年肿瘤患者因症状评估而到急诊科就诊的情况。两名评审员独立筛选引文并进行双重数据提取。采用描述性分析。
从 1298 篇引文筛选出 6 项前瞻性研究和 12 项回顾性描述性研究。其中 8 项研究关注多种症状，10 项研究针对特定症状。研究发表于 1995 年至 2011 年，来自 7 个国家，中位数样本量为 143（范围为 9-27644）。报告的 28 种症状中，最常见的是发热性中性粒细胞减少症、感染、疼痛、发热和呼吸困难。针对各症状提供的定义并不一致。在报告入院率的 16 项研究中，多症状研究中急诊就诊 58%（中位数）会导致住院（范围为 31%至 100%），而针对特定症状的研究中 100%（中位数）会导致住院（范围为 39%至 100%）。在报告死亡率的 11 项研究中，多症状研究中 13%（中位数）的急诊就诊（范围为 1%至 56%）和针对特定症状研究中 20%（中位数）的就诊导致死亡（范围为 4%至 67%）。
癌症患者因各种症状就诊于急诊科。超过一半的急诊科就诊导致住院。很少有症状得到充分定义，以便在研究间比较数据，这表明癌症症状报告存在重要的差距。
