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EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study
Background: We aimed to estimate the prevalence of cancer patients who presented to Emergency Departments (EDs), report their chief complaint and identify the predictors of 30-day all-cause mortality. Patients and methods: we undertook a prospective, cross-sectional study during three consecutive da...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291158/ https://www.ncbi.nlm.nih.gov/pubmed/32429507 http://dx.doi.org/10.3390/jcm9051505 |
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author | Peyrony, Olivier Fontaine, Jean-Paul Beaune, Sébastien Khoury, Abdo Truchot, Jennifer Balen, Frédéric Vally, Rishad Schmitt, Jacques Ben Hammouda, Kasarra Roussel, Mélanie Borzymowski, Céline Vallot, Cécile Sanh, Veronique Azoulay, Elie Chevret, Sylvie |
author_facet | Peyrony, Olivier Fontaine, Jean-Paul Beaune, Sébastien Khoury, Abdo Truchot, Jennifer Balen, Frédéric Vally, Rishad Schmitt, Jacques Ben Hammouda, Kasarra Roussel, Mélanie Borzymowski, Céline Vallot, Cécile Sanh, Veronique Azoulay, Elie Chevret, Sylvie |
author_sort | Peyrony, Olivier |
collection | PubMed |
description | Background: We aimed to estimate the prevalence of cancer patients who presented to Emergency Departments (EDs), report their chief complaint and identify the predictors of 30-day all-cause mortality. Patients and methods: we undertook a prospective, cross-sectional study during three consecutive days in 138 EDs and performed a logistic regression to identify the predictors of 30-day mortality in hospitalized patients. Results: A total of 1380 cancer patients were included. The prevalence of cancer patients among ED patients was 2.8%. The most frequent reasons patients sought ED care were fatigue (16.6%), dyspnea (16.3%), gastro-intestinal disorders (15.1%), trauma (13.0%), fever (12.5%) and neurological disorders (12.5%). Patients were admitted to the hospital in 64.9% of cases, of which 13.4% died at day 30. Variables independently associated with a higher mortality at day 30 were male gender (Odds Ratio (OR), 1.63; 95% CI, 1.04–2.56), fatigue (OR, 1.65; 95% CI, 1.01–2.67), poor performance status (OR, 3.00; 95% CI, 1.87–4.80), solid malignancy (OR, 3.05; 95% CI, 1.26–7.40), uncontrolled malignancy (OR, 2.27; 95% CI, 1.36–3.80), ED attendance for a neurological disorder (OR, 2.38; 95% CI, 1.36–4.19), high shock-index (OR, 1.80; 95% CI, 1.03–3.13) and oxygen therapy (OR, 2.68; 95% CI, 1.68–4.29). Conclusion: Cancer patients showed heterogeneity among their reasons for ED attendance and a high need for hospitalization and case fatality. Malignancy and general health status played a major role in the patient outcomes. This study suggests that the emergency care of cancer patients may be complex. Thus, studies to assess the impact of a dedicated oncology curriculum for ED physicians are warranted. |
format | Online Article Text |
id | pubmed-7291158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72911582020-06-17 EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study Peyrony, Olivier Fontaine, Jean-Paul Beaune, Sébastien Khoury, Abdo Truchot, Jennifer Balen, Frédéric Vally, Rishad Schmitt, Jacques Ben Hammouda, Kasarra Roussel, Mélanie Borzymowski, Céline Vallot, Cécile Sanh, Veronique Azoulay, Elie Chevret, Sylvie J Clin Med Article Background: We aimed to estimate the prevalence of cancer patients who presented to Emergency Departments (EDs), report their chief complaint and identify the predictors of 30-day all-cause mortality. Patients and methods: we undertook a prospective, cross-sectional study during three consecutive days in 138 EDs and performed a logistic regression to identify the predictors of 30-day mortality in hospitalized patients. Results: A total of 1380 cancer patients were included. The prevalence of cancer patients among ED patients was 2.8%. The most frequent reasons patients sought ED care were fatigue (16.6%), dyspnea (16.3%), gastro-intestinal disorders (15.1%), trauma (13.0%), fever (12.5%) and neurological disorders (12.5%). Patients were admitted to the hospital in 64.9% of cases, of which 13.4% died at day 30. Variables independently associated with a higher mortality at day 30 were male gender (Odds Ratio (OR), 1.63; 95% CI, 1.04–2.56), fatigue (OR, 1.65; 95% CI, 1.01–2.67), poor performance status (OR, 3.00; 95% CI, 1.87–4.80), solid malignancy (OR, 3.05; 95% CI, 1.26–7.40), uncontrolled malignancy (OR, 2.27; 95% CI, 1.36–3.80), ED attendance for a neurological disorder (OR, 2.38; 95% CI, 1.36–4.19), high shock-index (OR, 1.80; 95% CI, 1.03–3.13) and oxygen therapy (OR, 2.68; 95% CI, 1.68–4.29). Conclusion: Cancer patients showed heterogeneity among their reasons for ED attendance and a high need for hospitalization and case fatality. Malignancy and general health status played a major role in the patient outcomes. This study suggests that the emergency care of cancer patients may be complex. Thus, studies to assess the impact of a dedicated oncology curriculum for ED physicians are warranted. MDPI 2020-05-17 /pmc/articles/PMC7291158/ /pubmed/32429507 http://dx.doi.org/10.3390/jcm9051505 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Peyrony, Olivier Fontaine, Jean-Paul Beaune, Sébastien Khoury, Abdo Truchot, Jennifer Balen, Frédéric Vally, Rishad Schmitt, Jacques Ben Hammouda, Kasarra Roussel, Mélanie Borzymowski, Céline Vallot, Cécile Sanh, Veronique Azoulay, Elie Chevret, Sylvie EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study |
title | EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study |
title_full | EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study |
title_fullStr | EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study |
title_full_unstemmed | EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study |
title_short | EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study |
title_sort | epicancer—cancer patients presenting to the emergency departments in france: a prospective nationwide study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291158/ https://www.ncbi.nlm.nih.gov/pubmed/32429507 http://dx.doi.org/10.3390/jcm9051505 |
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