在诊断消化神经内分泌新生体之前,急诊室的访问模式
Omar Abdel-Rahman1, Sunita Ghosh2
1Department of Oncology, University of Alberta, Cross Cancer Institute, T6G 1Z2, Edmonton, AB, Canada. omar.abdelsalam@ahs.ca.
International journal of colorectal disease
|May 30, 2023
概括
几乎一半的消化神经内分泌瘤 (NENs) 患者在诊断前三个月内访问急诊室 (ED). 这些诊断前的ED访问与年轻的年龄,女性性别,晚期疾病,更高的并发症和更差的整体存活率有关.
科学领域:
- 胃肠道学和瘤学
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 消化神经内分泌瘤 (NENs) 是一种罕见的瘤,具有不同的临床表现.
- 了解诊断前的医疗保健利用情况,例如急诊室 (ED) 访问,可以提供有关诊断延迟和患者结果的见解.
研究的目的:
- 调查在诊断前三个月内患有消化神经内分泌瘤 (NENs) 的患者的急诊室 (ED) 访问的模式和相关因素.
- 评估这些诊断前ED访问对消化系统NEN患者的整体存活率的影响.
主要方法:
- 一项基于人口的队列研究,利用加拿大阿尔伯塔省 (2004-2019) 的链接行政数据库.
- 分析包括2120名被诊断患有消化系统NEN的患者,重点是组织学诊断前三个月内对ED访问.
- 采用多变量后勤和考克斯回归模型来确定与急救诊所访问相关的因素及其对生存的影响.
主要成果:
- 49.1%的患者在诊断前三个月内至少有一次ED访问.
- 与诊断前ED访问相关的因素包括年龄较小,女性性别,更高的并发症指数和晚期疾病阶段 (第四阶段).
- 诊断前的ED访问与更糟糕的整体存活率 (HR: 1.784) 有关.
结论:
- 很大一部分消化系统NEN患者在诊断前不久就出现在ED中,往往表明已晚期的疾病或显著的并发症.
- 诊断前的ED访问是消化系统NEN患者整体存活率较低的独立预测因素.
- 这些发现突出了早期诊断和干预的潜在机会,通过在ED环境中更好地识别NEN症状.
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