Tel Aviv Sourasky Medical Center, Tel-Aviv University, Tel Aviv, Israel.
The Gertner Institute For Epidemiology and Health Policy Research, Tel Aviv, Israel.
J Neurooncol. 2019 Jun;143(2):329-335. doi: 10.1007/s11060-019-03168-1. Epub 2019 May 3.
Radiotherapy departments function under workload pressure. We examined the process from referral to treatment initiation for spinal cord compression (SCC), one of the most daunting clinical scenarios in oncology.
We identified 235 patients with SCC, treated between 2013-2015. Two physicians classified cases as "emergent" or "urgent" (treatment within 24 or 72 h, respectively).
The distribution of referrals over the week was uniform for inpatients. In contrast, there was a referral peak (62.27%) during the first two workdays for emergency ambulatory patients (p = 0.011). There were few weekend referrals in all groups (3.0%). There was a statistically shorter interval between referral and treatment for emergent versus urgent cases (0.94 days vs. 4.17 days; p < 0.0001, Bonferroni correction p < 0.0005).
Time elapsed between referral and treatment of SCC may constitute a quality index in neuro-oncology. Modern departments of radiotherapy should determine the degree to which they can successfully implement such treatment. Patients with cancer and their physicians should be taught to recognize signs of SCC to expedite intervention.
放射治疗部门在工作负荷压力下运作。我们检查了从转诊到脊髓压迫（SCC）治疗开始的过程，这是肿瘤学中最令人生畏的临床情况之一。
我们确定了 235 名 SCC 患者，他们在 2013-2015 年间接受了治疗。两位医生将病例分为“紧急”或“紧急”（分别在 24 小时或 72 小时内治疗）。
住院患者的转诊分布在一周内均匀。相比之下，对于紧急门诊患者，第一个工作日的转诊高峰（62.27%）（p = 0.011）。所有组别的周末转诊都很少（3.0%）。与紧急情况相比，紧急情况和紧急情况之间的治疗间隔时间更短（0.94 天与 4.17 天；p < 0.0001，Bonferroni 校正 p < 0.0005）。
SCC 转诊和治疗之间的时间间隔可能构成神经肿瘤学中的一个质量指标。现代放射治疗部门应确定他们能够成功实施此类治疗的程度。应教导癌症患者及其医生识别 SCC 的迹象，以加快干预速度。
