晚期癌症患者临终时的急诊科就诊情况：模式、原因及可避免性
Emergency Department Visits at the End of Life of Patients With Terminal Cancer: Pattern, Causes, and Avoidability.
作者信息
Alsirafy Samy A, Raheem Ahmad A, Al-Zahrani Abdullah S, Mohammed Amrallah A, Sherisher Mohamed A, El-Kashif Amr T, Ghanem Hafez M
机构信息
Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Department of Medical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
出版信息
Am J Hosp Palliat Care. 2016 Aug;33(7):658-62. doi: 10.1177/1049909115581819. Epub 2015 Apr 15.
Frequent emergency department visits (EDVs) by patients with terminal cancer indicates aggressive care. The pattern and causes of EDVs in 154 patients with terminal cancer were investigated. The EDVs that started during working hours and ended by home discharge were considered avoidable. During the last 3 months of life, 77% of patients had at least 1 EDV. In total, 309 EDVs were analyzed. The EDVs occurred out of hour in 67%, extended for an average of 3.6 hours, and ended by hospitalization in 52%. The most common chief complaints were pain (46%), dyspnea (13%), and vomiting (12%). The EDVs were considered avoidable in 19% of the visits. The majority of patients with terminal cancer visit the ED before death, mainly because of uncontrolled symptoms. A significant proportion of EDVs at the end of life is potentially avoidable.
晚期癌症患者频繁前往急诊科就诊表明采取了积极的治疗措施。对154例晚期癌症患者急诊科就诊的模式及原因进行了调查。在工作时间开始并以出院回家结束的急诊科就诊被认为是可避免的。在生命的最后3个月里，77%的患者至少有1次急诊科就诊。总共分析了309次急诊科就诊情况。67%的急诊科就诊发生在非工作时间，平均持续3.6小时，52%以住院结束。最常见的主要症状是疼痛（46%）、呼吸困难（13%）和呕吐（12%）。19%的就诊被认为是可避免的。大多数晚期癌症患者在死亡前会前往急诊科就诊，主要原因是症状无法控制。生命末期相当一部分急诊科就诊可能是可以避免的。
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