First hospital contact via the Emergency Department is an independent predictor of overall survival and disease-free survival in patients with colorectal cancer
Por:
Tellez, T, Garcia-Aranda, M, Zarcos-Pedrinaci, I, Rivas-Ruiz, F, Perez-Ruiz, E, Padilla-Ruiz, M, Bare, M, Morales-Suarez-Varela, M, Rueda, A, Alcaide, J and Redondo, M
Publicada:
1 ene 2019
Resumen:
Aims: the aim of this study was to examine the possible association between the type of hospital admission and subsequent survival of the patient, as well as the pathological features recorded in a large population of patients with colorectal cancer.
Methods: the study included 1,079 patients diagnosed with colon or rectal cancer in the Hospital Costa del Sol (Marbella, Spain). The relationship between patient survival rate and type of first admission to the hospital (elective or emergency admission) was assessed. The following variables were studied: age, gender, tumor location, pathological stage, differentiation grade, chemotherapy before surgery and survival.
Results: colon tumors are more common in patients admitted to hospital for the first time via the emergency service (63.7%) and the tumors tend to be poorly differentiated (64.2%) and metastatic (70%). These patients also present a more aggressive disease and a poorer prognosis than patients with an elective admission. With regard to patients from the Emergency Department, a Cox regression analysis showed a risk-ratio (RR) of 1.36 (confidence interval [CI] 95%: 1.11-1.66) for disease-free survival and of 1.41 (95% CI: 1.14-1.76) for overall survival.
Conclusions: hospital admission via the Emergency Department is an indicator of aggressiveness and poorer prognosis compared to patients who enter via programmed routes.
Filiaciones:
Tellez, T:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Univ Malaga, Biochem & Immunol Dept, Malaga, Spain
Garcia-Aranda, M:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Hosp Costa del Sol, Res Unit, Ctra Cadiz,Km 187, Malaga 29603, Spain
Zarcos-Pedrinaci, I:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Hosp Costa del Sol, Hematol & Oncol Dept, Malaga, Spain
Rivas-Ruiz, F:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Perez-Ruiz, E:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Hosp Costa del Sol, Hematol & Oncol Dept, Malaga, Spain
Padilla-Ruiz, M:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Bare, M:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Univ Valencia, Food Sci Toxicol & Legal Med Dept, Publ Hlth Hyg & Environm Hlth Unit, Prevent Med & Publ Hlth, Valencia, Spain
:
Adv Res Publ Hlth Ctr CSISP FISABIO, Valencia, Spain
Inst Salud Carlos III, CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain
Univ Malaga, Oncol & Hematol Dept, Malaga, Spain
Rueda, A:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Hosp Costa del Sol, Hematol & Oncol Dept, Malaga, Spain
Malaga Biomed Res Inst IBIMA, Malaga, Spain
Alcaide, J:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Hosp Costa del Sol, Hematol & Oncol Dept, Malaga, Spain
Malaga Biomed Res Inst IBIMA, Malaga, Spain
Redondo, M:
Hosp Costa del Sol, Res Network Hlth Serv Chron Dis REDISSEC, Res Unit, Malaga, Spain
Hosp Costa del Sol, Res Unit, Ctra Cadiz,Km 187, Malaga 29603, Spain
Univ Malaga, Biochem & Immunol Dept, Malaga, Spain
Malaga Biomed Res Inst IBIMA, Malaga, Spain
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