紧急报告预测胰腺癌患者的结果会更差
Natalia Khalaf1,2, Basim Ali3, Yan Liu4,3
1Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd. MS:111-D, Houston, TX, 77030, USA. natalia.khalaf@bcm.edu.
Digestive diseases and sciences
|December 16, 2023
概括
通过紧急呈现 (EP) 诊断的胰腺癌是常见的,并且与更糟糕的结果有关. 患有EP的患者接受的治疗较少,死亡风险更高,突出了关键护理缺口.
科学领域:
- 在瘤学瘤学.
- 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:
- 癌症的紧急呈现 (EP),在急诊室 (ED) 诊断,与患者的治疗结果较差和医疗保健系统压力的增加有关.
- 在欧洲的研究中,胰腺癌的EP率很高,但在美国仍未得到充分研究.
研究的目的:
- 调查胰腺癌EP与癌症阶段,治疗接收和患者存活率之间的关联.
- 确定潜在的护理缺口,并为胰腺癌诊断和管理提供质量改善计划的信息.
主要方法:
- 在2007年至2019年期间在退伍军人事务医疗中心诊断的胰腺腺癌患者的回顾性队列研究.
- 分析了电子健康记录以确定EP病例 (在怀疑患有癌症的ED访问后30天内诊断).
- 使用多变量逻辑回归和Cox比例危险模型来评估EP与临床结果之间的关联.
主要成果:
- 在243名胰腺癌患者中,66.7%通过EP诊断出胰腺癌,癌症阶段没有差异.
- EP患者接受癌症治疗的可能性降低了72% (调整后OR为0.28).
- EP患者面临73%的死亡风险 (调整HR1.73),在调整阶段和治疗后 (调整HR1.47) 持续存在.
结论:
- 胰腺癌EP是普遍存在的,并且独立地与治疗率和生存率的降低有关.
- 了解导致EP的过程分解对于识别护理差距至关重要.
- 质量改善工作应集中在减轻EP对胰腺癌患者治疗结果的负面影响上.
相关概念视频
01:30Acute Pancreatitis II: Clinical Manifestations and Management
125
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
125
01:29Chronic Pancreatitis II: Collaborative Care
92
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
92
01:24Chronic Pancreatitis I: Introduction
90
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
90
01:26Endoscopic Procedures V: ERCP
258
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
258
01:21Cancer Survival Analysis
355
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
355