Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department.
Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department.
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急诊科晚期癌症患者的姑息治疗需求和临床结果。
DOI：
10.1089/jpm.2021.0567
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发表时间：
2022
影响因子：
2.8
通讯作者：
Hudson,MatthewF
中科院分区：
文献类型：
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作者：
Yilmaz,Sule;Grudzen,CoritaR;Durham,DanielleD;McNaughton,Caroline;Marcelin,Isabelle;Abar,Beau;Adler,David;Bastani,Aveh;Baugh,ChristopherW;Bernstein,StevenL;Bischof,JasonJ;Coyne,ChristopherJ;Henning,DanielJ;Hudson,MatthewF
背景：老年癌症患者急诊科（ED）急症治疗。目的：在ed中描述晚期癌症患者的姑息治疗需求和临床结果。设计：对综合肿瘤急诊研究网络（CONCERN）数据进行有计划的二次数据分析。背景/对象：美国18家CONCERN附属急诊科的癌症患者。测量方法：调查包括人口统计学、癌症类型、功能状态、症状负担、姑息治疗和临终关怀登记，以及预先指示代码状态。结果：674/1075例患者中有62.3%为晚期癌症，以白人（78.6%）和女性（50.3%）居多；中位年龄为64岁（四分位数间54-71岁）。一小部分患者接受姑息治疗（6.5%[95%可信区间；CI 3.0-7.6];p= 0.005）和临终关怀（1.3% [95% CI 1.0-3.2];p= 0.52），且30天死亡率较高（8.3%,[95% CI 6.2-10.4]）。结论：晚期癌症患者继续出现在急诊科，尽管建议早期提供姑息治疗。
Background:Older adults with cancer use the emergency department (ED) for acute concerns.Objectives:Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED.Design:A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data.Settings/Subjects:Cancer patients who presented to the 18 CONCERN affiliated EDs in the United States.Measurements:Survey included demographics, cancer type, functional status, symptom burden, palliative and hospice care enrollment, and advance directive code status.Results:Of the total (674/1075, 62.3%) patients had advanced cancer and most were White (78.6%) and female (50.3%); median age was 64 (interquartile range 54–71) years. A small proportion of them were receiving palliative (6.5% [95% confidence interval; CI 3.0–7.6];p= 0.005) and hospice (1.3% [95% CI 1.0–3.2];p= 0.52) care and had a higher 30-day mortality rate (8.3%, [95% CI 6.2–10.4]).Conclusions:Patients with advanced cancer continue to present to the ED despite recommendations for early delivery of palliative care.