Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Cancer. 2021 Jul 15;127(14):2553-2561. doi: 10.1002/cncr.33534. Epub 2021 Mar 19.
Emergency department (ED) utilization and emergency admissions by patients with cancer have increased. The authors aimed to evaluate the characteristics of patients with cancer admitted through the ED and determine whether cancer types are related to in-hospital mortality.
The National Emergency Department Information System database of patients visiting EDs in South Korea between 2016 and 2017 was analyzed. Among 6,179,088 adult patients who presented to an ED with nontraumatic medical illness, patients with cancer were identified. The primary outcome was in-hospital mortality.
Patients with cancer accounted for 6.8% of ED visits, and 239,630 patients (57.0%) were admitted to the hospital (intensive care unit [ICU], 9.5%; others, 90.5%). The prevalent cancers requiring hospitalization were lung cancer (15.7%), liver cancer (14.2%), and colon cancer (11.6%). The commonest reasons for admission other than cancer-related medical problems (41.4%) were pneumonia (4.8%) and hepatobiliary infection (2.8%). Overall in-hospital mortality was 16.1% (ICU, 28.3%; general wards, 14.8%); lung cancer (22.9%), liver cancer (19.7%), and leukemia/multiple myeloma (17.8%) showed the highest mortality rates. The highest odds for mortality were for lung cancer (adjusted odds ratio [OR], 2.227; 95% confidence interval [CI], 2.124-2.335; P < .001) and liver cancer (adjusted OR, 1.839; 95% CI, 1.751-1.930; P < .001), which were referenced to genitourinary cancer by multivariable logistic regression analysis.
More than half of the patients with cancer visiting EDs were admitted to the hospital with a mortality rate of 16.1%. Physicians treating patients with cancer and policymakers and planners designing health systems should understand the different prevalences and outcomes of oncological emergencies by cancer type to improve patient care.
前往急诊科（ED）就诊的癌症患者和因癌症而住院的人数有所增加。作者旨在评估通过 ED 收治的癌症患者的特征，并确定癌症类型是否与住院死亡率相关。
分析了 2016 年至 2017 年期间韩国急诊科就诊的非创伤性内科疾病成年患者的国家急诊科信息系统数据库。确定患有癌症的患者。主要结局是院内死亡率。
癌症患者占 ED 就诊患者的 6.8%，239630 名患者（57.0%）住院（重症监护病房[ICU]，9.5%；其他，90.5%）。需要住院治疗的常见癌症为肺癌（15.7%）、肝癌（14.2%）和结肠癌（11.6%）。除癌症相关医疗问题外，最常见的住院原因是肺炎（4.8%）和肝胆感染（2.8%）。总体院内死亡率为 16.1%（ICU，28.3%；普通病房，14.8%）；肺癌（22.9%）、肝癌（19.7%）和白血病/多发性骨髓瘤（17.8%）死亡率最高。死亡率最高的是肺癌（调整后的优势比[OR]，2.227；95%置信区间[CI]，2.124-2.335；P<.001）和肝癌（调整后的 OR，1.839；95% CI，1.751-1.930；P<.001），这两种癌症与多变量逻辑回归分析中参考的泌尿系统癌症相比。
超过一半的前往 ED 就诊的癌症患者住院治疗，死亡率为 16.1%。治疗癌症患者的医生以及制定卫生系统政策和规划的决策者应该了解不同癌症类型的肿瘤急症的不同患病率和结果，以改善患者护理。
