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Rev Esp Enferm Dig. 2019 Jul 26;111. doi: 10.17235/reed.2019.5777/2018. [Epub ahead of print]

First hospital contact via the Emergency Department is an independent predictor of overall survival and disease-free survival in patients with colorectal cancer.

Author information

1
Hospital Costa del Sol.
2
Corporació Sanitaria Parc Tauli.
3
Universidad de Valencia.
4
Departamento de Hematología y Oncología, Hospital Costa del Sol.
5
Bioquímica, Hospital Costa del Sol, ESPAÑA.

Abstract

AIMS:

the aim of this study was to examine the possible association between the type of hospital admission and subsequent survival of the patient, as well as the pathological features recorded in a large population of patients with colorectal cancer.

METHODS:

the study included 1,079 patients diagnosed with colon or rectal cancer in the Hospital Costa del Sol (Marbella, Spain). The relationship between patient survival rate and type of first admission to the hospital (elective or emergency admission) was assessed. The following variables were studied: age, gender, tumor location, pathological stage, differentiation grade, chemotherapy before surgery and survival.

RESULTS:

colon tumors are more common in patients admitted to hospital for the first time via the emergency service (63.7%) and the tumors tend to be poorly differentiated (64.2%) and metastatic (70%). These patients also present a more aggressive disease and a poorer prognosis than patients with an elective admission. With regard to patients from the Emergency Department, a Cox regression analysis showed a risk-ratio (RR) of 1.36 (confidence interval [CI] 95%: 1.11-1.66) for disease-free survival and of 1.41 (95% CI: 1.14-1.76) for overall survival.

CONCLUSIONS:

hospital admission via the Emergency Department is an indicator of aggressiveness and poorer prognosis compared to patients who enter via programmed routes.

PMID:
31345043
DOI:
10.17235/reed.2019.5777/2018
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