Workina Abdata, Habtamu Asaminew, Zewdie Wondeson
Department of Nursing, Jimma University, Jimma, Oromia, Ethiopia.
Department of Emergency, Jimma University Medical Centre, Jimma, Oromia, Ethiopia.
Open Access Emerg Med. 2022 Oct 28;14:581-590. doi: 10.2147/OAEM.S381816. eCollection 2022.
The number of oncologic patients visiting the emergency department (ED) is increasing and represent a challenge for the emergency team owing to they might have acute sign and symptoms of a still undiagnosed malignancy, management of treatment-related side effects, co-morbidities, and palliative care. Thus, this study was aimed to identify reasons for ED visits, management outcomes, and associated factors of oncologic patients.
A prospective cross-sectional study was conducted from March 11, 2021 to August 25, 2021 at the ED of Jimma University Medical Center on a total of 338 oncologic patients. Data were collected from the patient and the patient's medical record using a questionnaire developed from up-to-date similar literatures. The questionnaire was started filled out upon diagnosis of cancer and completed during discharge from the ED. The outcomes of the patients were dichotomized into died and survived then, it was analyzed using frequency and bivariate logistic regression.
The most common reasons for oncologic patients ED visit were neutropenic fever 79 (23.4%) followed by vomiting 38 (11.2%) and electrolyte abnormality 37 (10.9%) respectively. Among oncologic patients visited ED, 137 (40.5%) of them were admitted to ward and 126 (37.3%) of them were discharged with improvement while 64 (18.9%) of them were died. Based on multivariate logistic regression, those patients who had distant metastasis cancer (AOR 1.85; 95% CI 1.03-7.21), comorbidity (AOR 2.56; 95% CI 1.20, 6.96), and ECOG >3 (AOR 2.40; 95% CI 1.25,13.43) were more likely to die than their counterparts.
Most of the oncologic patients visited ED due to neutropenic fever, nausea and or vomiting, and electrolyte disorder. Amongst oncologic patients who were visited ED, most of them were admitted to ward while around one-fifth of them were died. Having distant metastasis cancer, comorbidity and ECOG >3 were independent predictors of an oncologic patient's outcome at the ED.
前往急诊科（ED）就诊的肿瘤患者数量正在增加，这对急诊团队来说是一项挑战，因为他们可能有尚未确诊的恶性肿瘤的急性体征和症状、治疗相关副作用的管理、合并症以及姑息治疗。因此，本研究旨在确定肿瘤患者前往急诊科就诊的原因、管理结果及相关因素。
2021年3月11日至2021年8月25日，在吉马大学医学中心急诊科对338例肿瘤患者进行了一项前瞻性横断面研究。使用从最新类似文献中开发的问卷从患者及其病历中收集数据。问卷在癌症诊断时开始填写，并在从急诊科出院时完成。患者的结局分为死亡和存活，然后使用频率和二元逻辑回归进行分析。
肿瘤患者前往急诊科就诊的最常见原因分别是中性粒细胞减少性发热79例（23.4%），其次是呕吐38例（11.2%）和电解质异常37例（10.9%）。在前往急诊科就诊的肿瘤患者中，137例（40.5%）被收入病房，126例（37.3%）病情好转出院，64例（18.9%）死亡。基于多因素逻辑回归分析，有远处转移癌的患者（比值比1.85；95%置信区间1.03 - 7.21）、合并症患者（比值比2.56；95%置信区间1.20, 6.96）以及东部肿瘤协作组（ECOG）评分>3的患者（比值比2.40；95%置信区间1.25, 13.43）比其他患者更有可能死亡。
大多数肿瘤患者因中性粒细胞减少性发热、恶心和/或呕吐以及电解质紊乱前往急诊科就诊。在前往急诊科就诊的肿瘤患者中，大多数被收入病房，但约五分之一的患者死亡。有远处转移癌、合并症以及ECOG评分>3是肿瘤患者在急诊科结局的独立预测因素。
