癌症患者与住院情况：疾病轨迹与战略选择

Patients with cancer and hospital admissions: disease trajectory and strategic choices.

作者信息

Numico Gianmauro, Ferrua Rachele, Fea Elena, Giamello Jacopo, Colantonio Ida, Occelli Marcella, Vandone Anna Maria, Vanella Paola, Aimar Giacomo, Pisano Chiara, Parlagreco Elena, Persano Irene, Milanesio Michela, Ippoliti Roberto

机构信息

Medical Oncology, AO S.Croce e Carle, Cuneo, Italy

Medical Oncology, AO S.Croce e Carle, Cuneo, Italy.

出版信息

BMJ Support Palliat Care. 2023 Sep 13. doi: 10.1136/spcare-2023-004574.

DOI:10.1136/spcare-2023-004574

PMID:37704262

Abstract

OBJECTIVES

Hospital admission (HA) in cancer history is a common, repeated and frequently unplanned event. The emergency departments (EDs) and the oncological outpatient service (OOS) are the ordinary way of entry. We studied the reasons of admission, pathways of access and discharge and prognostic factors in a population of admitted patients with cancer.

METHODS

The health records of the admitted patients in the oncological ward of a referral hospital in a 6-month period were retrieved and analysed. The characteristics of those admitted in the last 3 months of life were compared with the other group.

RESULTS

Among the 147 HA, 79.5% were unplanned, 48.9% passing through the ED and 30.6% through the OOS; 56.5% were due to cancer-related symptoms; 50.3% occurred in the last 3 months of life. Median overall survival was 90 days (95% IC 53.1-126.9). Independent prognostic factors for survival were: being admitted for symptoms, referral through the ED and not being discharged at home.

CONCLUSIONS

Hospital is a turning point in the cancer care pathway. Patients needing HA have a dismal prognosis, half of them being in the last 3 months of life. This group can be identified using universally available variables.

摘要

目的

有癌症病史的患者住院是一种常见、反复且常为非计划性的事件。急诊科（ED）和肿瘤门诊服务（OOS）是常规的入院途径。我们研究了癌症住院患者的入院原因、就诊途径和出院情况以及预后因素。

方法

检索并分析了一家转诊医院肿瘤病房6个月期间住院患者的健康记录。将生命最后3个月内入院患者的特征与另一组进行比较。

结果

在147例住院病例中，79.5%为非计划性住院，48.9%通过急诊科入院，30.6%通过肿瘤门诊服务入院；56.5%是由于癌症相关症状；50.3%发生在生命的最后3个月。中位总生存期为90天（95%置信区间53.1 - 126.9）。生存的独立预后因素为：因症状入院、通过急诊科转诊以及未在家中出院。