Casanovas Blanco Meritxell
Melbourne School of Health Sciences, The University of Melbourne, Carlton, Victoria, Australia.
Eur J Cancer Care (Engl). 2019 Mar;28(2):e12974. doi: 10.1111/ecc.12974. Epub 2018 Dec 5.
Recent worldwide advances in cancer therapies have resulted in an increased number of people receiving chemotherapy in ambulatory care settings. In Spain, emergency departments are the single point of entry to acute inpatient services and they play a pivotal role in the management of chemotherapy complications. Little research exists in patterns of emergency department utilisation by oncology patients with chemotherapy-related complications. However, it is important for the oncology patients and the healthcare system to gain understanding in the disease pathway and the organisational factors influencing the quality of care.
This critical review's main aims were to describe the clinical characteristics of patients who presented to an emergency department after chemotherapy treatment as reported in international literature; to map reported patterns of care in emergency department access; and quality of care exploring the management of febrile neutropenic patients described in the literature, against best practice guidelines.
The search strategy yield 701 articles from MEDLINE, TROVE and SCOPUS and 26 were included. The review combines systematic reviews, observational, cross-sectional case-control studies and randomised control trials.
All articles showed areas and opportunities for improvement in the management of this population, especially with regard to time from triage to antibiotic administration in febrile neutropenic patients.
近期全球癌症治疗取得的进展使得在门诊接受化疗的人数有所增加。在西班牙，急诊科是急性住院服务的唯一入口，在化疗并发症的管理中起着关键作用。关于肿瘤患者化疗相关并发症在急诊科的就诊模式，相关研究较少。然而，了解疾病路径以及影响护理质量的组织因素对于肿瘤患者和医疗系统而言都很重要。
本综述的主要目的是描述国际文献中报道的化疗后前往急诊科就诊患者的临床特征；梳理报道的急诊科就诊护理模式；并对照最佳实践指南，探讨文献中描述的发热性中性粒细胞减少患者的护理质量。
检索策略从MEDLINE、TROVE和SCOPUS数据库中检索到701篇文章，纳入了26篇。该综述结合了系统评价、观察性研究、横断面病例对照研究和随机对照试验。
所有文章均显示了在这一人群管理方面有待改进的领域和机会，尤其是在发热性中性粒细胞减少患者从分诊到使用抗生素的时间方面。
