在加拿大安大略省癌症诊断之前的急诊室使用:基于人口的研究
Keerat Grewal1, Andrew Calzavara2, Shelley L McLeod2
1Schwartz/Reisman Emergency Medicine Institute (Grewal, McLeod, Thompson, Borgundvaag, Ovens, Mohindra), Sinai Health; Division of Emergency Medicine (Grewal, Mohindra), Department of Medicine, Temerty Faculty of Medicine, University of Toronto; ICES Central (Grewal, Calzavara, Eskander, Savage, Krzyzanowska, Sutradhar); Dalla Lana School of Public Health (McLeod, Eskander, Thompson, Sutradhar), Temerty Faculty of Medicine, University of Toronto; Department of Family and Community Medicine (McLeod, Borgundvaag, Ovens, Cheskes, Walsh), Temerty Faculty of Medicine, University of Toronto; Sunnybrook Health Sciences Centre and Odette Cancer Centre (Eskander, Krzyzanowska); Department of Otolaryngology - Head & Neck Surgery (Eskander, Irish), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Savage), Thunder Bay Regional Health Sciences Centre; NOSM University (Savage), Thunder Bay, Ont.; Sunnybrook Centre for Prehospital Medicine (Cheskes), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Emergency Medicine (de Wit), Queen's University, Kingston, Ont.; Division of Emergency Medicine (de Wit), Department of Medicine, McMaster University, Hamilton, Ont.; University Health Network (Irish); Ontario Health-Cancer Care Ontario (Irish); Division of Medical Oncology (Krzyzanowska), Department of Medicine, Temerty Faculty of Medicine, University of Toronto; North York General Hospital (Mohindra), Toronto, Ont.; Department of Emergency Medicine and the School of Epidemiology and Public Health (Thiruganasambandamoorthy), University of Ottawa; The Ottawa Hospital Research Institute (Thiruganasambandamoorthy), Ottawa, Ont. Keerat.grewal@sinaihealth.ca.
在安大略省,大约三分之一的癌症患者在诊断前90天内访问急诊室. 农村,边缘化和特定的癌症类型与急诊室使用率的增加有关.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在癌症诊断之前,急诊室 (ED) 的使用情况尚不清楚.
- 在确认癌症诊断之前调查ED访问对于早期检测和干预策略至关重要.
研究的目的:
- 描述在安大略省癌症诊断前90天急诊室使用的模式.
- 在确诊癌症诊断之前,识别与急诊室利用相关的因素.
主要方法:
- 一个回顾性,以人口为基础的研究,利用加拿大安大略省的链接行政数据库.
- 包括2014年至2021年期间被诊断患有癌症的651,071名成年患者.
- 多变量后勤回归分析以评估ED使用与人口,临床和医疗保健准入因素之间的关联.
主要成果:
- 35.3%的癌症患者在诊断前90天内进行ED访问; 51.4%被录取.
- 诊断前使用ED的可能性增加与农村,安大略省北部居住和更高水平的社会经济边缘化有关.
- 特定的癌症类型,包括内癌,胰腺癌,肝/胆囊癌和胸腔癌,在诊断前的ED访问率显著增加.
结论:
- 在安大略省,在正式诊断癌症之前,大量患者的急诊室访问是常见的.
- 了解前诊断ED使用的驱动因素至关重要,特别是在农村或边缘化地区的弱势群体和某些癌症类型中.
- 这些发现突出了改善癌症查和诊断途径的机会,可能减少对癌症相关初始担忧的急救服务的依赖.


