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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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.
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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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