Russell Emma R, Kumar Yash, Tripathi Raghav, Carroll Bryan T
Case Western Reserve University School of Medicine, 1924 E 86th Street, Cleveland, OH, 44106, USA.
Department of Dermatology, Johns Hopkins, Baltimore, USA.
Arch Dermatol Res. 2023 May;315(4):825-830. doi: 10.1007/s00403-022-02442-z. Epub 2022 Nov 4.
Skin cancer-related emergency department (ED) visits are among the most common cancer-related ED visits in the USA. However, ED utilization among skin cancer patients has not been evaluated. To assess overall utilization of EDs among skin cancer patients, reasons for skin cancer-related visits, and factors associated with inpatient admission. This was a retrospective, cross-sectional study of adults with skin cancer presenting to EDs using years 2013-2015 of the Nationwide Emergency Department Sample. In total, 693,835 of the 223,329,909 weighted ED visits were made by patients with skin cancer. Visits among this population were frequently due to age-related comorbidities and skin cancer treatment-specific adverse events. Melanoma accounted for the minority of skin cancer-related visits (27.58%), but over half of subsequent inpatient admissions (51.18%) and was associated with greater odds of inpatient admission compared to keratinocyte carcinoma (OR 1.278, 95% CI 1.264-1.293). Treatment and staging codes were not available, and thus, differences in ED utilization among skin cancer stages and treatment approaches could not be assessed. Ultimately, these findings are important in improving anticipatory outpatient care for patients with skin cancer and in guiding appropriate management of this unique population in the ED.
与皮肤癌相关的急诊科就诊是美国最常见的与癌症相关的急诊科就诊类型之一。然而,皮肤癌患者的急诊科利用率尚未得到评估。目的是评估皮肤癌患者对急诊科的总体利用率、皮肤癌相关就诊的原因以及与住院入院相关的因素。这是一项回顾性横断面研究,研究对象为2013 - 2015年使用全国急诊科样本数据的成年皮肤癌患者。在总计223,329,909次加权急诊科就诊中,有693,835次是由皮肤癌患者进行的。该人群的就诊频繁是由于与年龄相关的合并症以及皮肤癌治疗特有的不良事件。黑色素瘤占与皮肤癌相关就诊的少数(27.58%),但在随后的住院入院中占比超过一半(51.18%),并且与角质形成细胞癌相比,住院入院的几率更高(比值比1.278,95%置信区间1.264 - 1.293)。治疗和分期代码不可用,因此无法评估皮肤癌不同阶段和治疗方法之间的急诊科利用率差异。最终,这些发现对于改善皮肤癌患者的预期门诊护理以及指导急诊科对这一特殊人群的适当管理具有重要意义。