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疑似肉瘤的诊断途径:症状和临床检查结果对诊断过程的影响。

Routes to Diagnosis for Suspected Sarcoma: The Impact of Symptoms and Clinical Findings on the Diagnostic Process.

作者信息

Buvarp Dyrop Heidi, Vedsted Peter, Rædkjær Mathias, Safwat Akmal, Keller Johnny

机构信息

Sarcoma Center of Aarhus University Hospital, Aarhus C, Denmark; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus C, Denmark.

The Research Unit for General Practice, Research Center for Cancer Diagnosis, Aarhus University, Aarhus C, Denmark.

出版信息

Sarcoma. 2016;2016:8639272. doi: 10.1155/2016/8639272. Epub 2016 Dec 26.

Abstract

. Sarcoma patients often experience delay before diagnosis. We examined the association between presenting symptoms/signs and time intervals for suspected sarcoma patients. . 545 consecutive patients suspected for sarcoma referred over a one-year period were included. Median time intervals in routes to diagnosis were collected from medical records and questionnaires. . 102 patients (18.7%) had a sarcoma; 68 (12.5%) had other malignancies. Median interval for the patient (time from first symptom to first doctor visit), primary care, local hospital, sarcoma center, diagnostic, and total interval for sarcoma patients were 77, 17, 29, 17, 65, and 176 days, respectively. Sarcoma patients visited more hospital departments and had longer median primary care (+10 days) and diagnostic intervals (+19 days) than patients with benign conditions. Median primary care (-19 days) and sarcoma center (-4 days) intervals were shorter for patients with a lump versus no lump. Median patient (+40 days), primary care (+12 days), diagnostic (+17 days), and total intervals (+78 days) were longer for patients presenting with pain versus no pain. GP suspicion of malignancy shortened local hospital (-20 days) and total intervals (-104 days). . The main part of delay could be attributed to the patient and local hospitals. Length of time intervals was associated with presenting symptoms/signs and GP suspicion.

摘要

肉瘤患者在确诊前常常经历延迟。我们研究了疑似肉瘤患者的症状/体征与时间间隔之间的关联。纳入了在一年期间转诊的545例连续疑似肉瘤患者。从病历和问卷中收集诊断过程中的中位时间间隔。102例患者(18.7%)患有肉瘤;68例(12.5%)患有其他恶性肿瘤。肉瘤患者从首次出现症状到首次就诊、基层医疗、当地医院、肉瘤中心、诊断以及总间隔的中位时间分别为77天、17天、29天、17天、65天和176天。与良性疾病患者相比,肉瘤患者就诊的医院科室更多,基层医疗(多10天)和诊断间隔(多19天)的中位时间更长。有肿块的患者基层医疗(少19天)和肉瘤中心(少4天)间隔的中位时间较短。有疼痛症状的患者从首次出现症状到首次就诊(多40天)、基层医疗(多12天)、诊断(多17天)以及总间隔(多78天)的中位时间更长。全科医生怀疑为恶性肿瘤可缩短当地医院(少20天)和总间隔(少104天)。延迟的主要部分可归因于患者和当地医院。时间间隔的长短与症状/体征以及全科医生的怀疑有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a0e/5220485/4585a628232d/SARCOMA2016-8639272.001.jpg

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