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Critical laboratory result reporting system in cancer patients
Chang-I Chen1, James Miser, Ching-Feng Kuan
1Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Hypothesis:
Automatic transmission of computer-generated Critical Laboratory Result Reports (CLRRs) to physicians can improve the care of advanced cancer patients by improving the communication efficacy of important medical information.
Method:
We followed a cohort of 2012 cancer patients from diagnosis to five years or to death if it occurred before five years from diagnosis. The incidence and number of CLRRs and their association with diagnosis, age, gender, tumor size, and clinical staging were evaluated. The CLRRs that were reported included for example: glucose<40 or>500, hemoglobin<6.0. (Appendix 1)
Results:
Two thousand, twelve patients with cancer were included in the study; 45.6 percent had one or more critical laboratory results that required a CLRR. Older patients greater than or equal to 75 years of age had more CLRRs than younger patients. Patients with colorectal, liver, and lung cancer had a significantly higher number of CLRRs. More CLRRs were also seen in late-staged cancers. These conditions also have higher mortality rates.
Conclusion:
Critical values are common in patients with cancer, especially older patients with advanced disease. They occur more commonly with some cancers of liver and lung cancers. Our data demonstrate that critical laboratory values can be transmitted successfully to physicians. The impact of this system promises to improve the care of these individuals' serious illnesses. A prospective study to demonstrate the benefit of this system is being planned.
