Title
Patients with end-stage oncologic and nononcologic disease in emergency service of an Urban Tertiary Hospital
Date Issued
01 January 2018
Access level
metadata only access
Resource Type
journal article
Publisher(s)
Medknow Publications
Abstract
Context: In the last decades, patients with chronic terminal diseases have had more frequent visits to emergency services. Aims: This study aims to determine the proportion of terminal illness in patients readmitted to emergency room, to evaluate the use of this service and rate of death. Settings and Design: A cross-sectional study in a tertiary hospital with 120 stretchers which annually reports 160 thousand attentions and 22 thousand admissions. Subjects and Methods: Included 18-year-old patients or older who were readmitted to emergency room. Patient and/or caregiver were interviewed; medical record was reviewed and made 1-year follow-up. Terminal cancer was determined by histologically confirmation in Stage IV and nononcologic terminal disease by total functional dependence (Katz index) or severe cognitive impairment (Pfeiffer questionnaire) in addition of advanced organ failure. Statistical Analysis Used: Fisher's exact and U of Mann-Whitney tests for two independent samples. Results: Ninety-two (26%) of 349 were readmissions; 29 (36.7%) of 79 evaluated patients were identifying with terminal disease. Eleven (38%) of them had cancer (genitourinary in 64%). Nononcologic terminal disease was identified in 18 cases (62%) (Neurodegenerative involvement in 50%). More frequent symptoms were dyspnea 41%, mental confusion 24%, and pain 21%. Terminal patients had 6.2 (standard deviation 8.2) emergency visits at last year, being admitted 48,6% of these visits. Six-month mortality rate was 73 and 61% in oncologic and nononcolgic patients, respectively (P < 0.05). Conclusions: End-stage disease is frequent in readmitted patients to emergency, more of nononcologic kind. These patients use frequently emergency service, with high mortality (more elevated in oncologic).
Start page
25
End page
27
Volume
24
Issue
1
Language
English
OCDE Knowledge area
Oncología
Subjects
Scopus EID
2-s2.0-85042309370
Source
Indian Journal of Palliative Care
ISSN of the container
09731075
Sources of information:
Directorio de Producción Científica
Scopus