SUNY Downstate Medical Center, Brooklyn, New York; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
J Am Acad Dermatol. 2018 Jun;78(6):1102-1109. doi: 10.1016/j.jaad.2017.12.031. Epub 2017 Dec 19.
Dermatologic conditions cause morbidity and mortality among hospitalized cancer patients. An improved understanding is critical for implementing clinical and research programs in inpatient oncodermatology.
To characterize inpatient dermatology consultations at a large comprehensive cancer center.
Retrospective database query of new admissions and medical record review of initial inpatient dermatology consultations comparing inpatients consulted and not consulted during January-December 2015.
In total, 412 of 11,533 inpatients received 471 dermatology consultations (54% male, median age 59.5 years). Patients with hematologic cancers were 6 times more likely to receive dermatologic consultations compared with nonhematologic cancers (odds ratio 6.56, 95% confidence interval 5.35-8.05, P < .0001). Patients consulted by a dermatologist had a significantly longer length of stay than inpatients not consulted by dermatology (median 11 vs 5 days, P < .0001). Among the 645 dermatologic conditions diagnosed, the most common categories were inflammatory diseases, infections, and drug reactions; the most frequent conditions were contact dermatitis, herpes zoster, and chemotherapy-induced drug eruptions.
The study's retrospective nature and single-institution setting are potential limitations.
Hematologic malignancies are a significant risk factor for dermatology inpatient consultations. A significantly longer length of stay was associated with dermatology consultations, suggesting high comorbidities in these patients. Increased dermatologic care of these inpatients might improve quality of life, dermatologic health, and ability to receive anticancer agents.
皮肤科疾病会导致住院癌症患者的发病率和死亡率。深入了解这一问题对于实施住院肿瘤皮肤科的临床和研究项目至关重要。
描述一家大型综合性癌症中心的住院皮肤科会诊情况。
对 2015 年 1 月至 12 月新入院患者的数据库进行回顾性查询，并对首次住院皮肤科会诊的病历进行回顾性分析，比较了接受和未接受皮肤科会诊的住院患者。
共有 11533 名住院患者中的 412 名（54%为男性，中位年龄为 59.5 岁）接受了 471 次皮肤科会诊。与非血液系统癌症相比，血液系统癌症患者接受皮肤科会诊的可能性要高出 6 倍（比值比 6.56，95%置信区间 5.35-8.05，P<.0001）。与未接受皮肤科会诊的住院患者相比，接受皮肤科医生会诊的患者住院时间明显更长（中位数分别为 11 天和 5 天，P<.0001）。在诊断的 645 种皮肤科疾病中，最常见的类别是炎症性疾病、感染和药物反应；最常见的疾病是接触性皮炎、带状疱疹和化疗药物性皮疹。
本研究为回顾性研究且仅在一家机构开展，可能存在一定局限性。
血液系统恶性肿瘤是住院皮肤科会诊的一个重要危险因素。与皮肤科会诊相关的是显著延长的住院时间，这表明这些患者存在较高的合并症。增加对这些住院患者的皮肤科护理可能会提高他们的生活质量、皮肤健康和接受抗癌药物治疗的能力。
