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http://hdl.handle.net/2445/146974
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DC Field | Value | Language |
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dc.contributor.author | Porta, Miquel, 1957- | - |
dc.contributor.author | Fernández Muñoz, Esteve | - |
dc.contributor.author | Belloc, J. | - |
dc.contributor.author | Malats, Núria | - |
dc.contributor.author | Alonso, J. | - |
dc.date.accessioned | 2019-12-18T18:06:17Z | - |
dc.date.available | 2019-12-18T18:06:17Z | - |
dc.date.issued | 1998-02-01 | - |
dc.identifier.issn | 0007-0920 | - |
dc.identifier.uri | http://hdl.handle.net/2445/146974 | - |
dc.description.abstract | The objective of this study was to compare the pre-hospital health care process, clinical characteristics at admission and survival of patients with a digestive tract cancer first admitted to hospital either electively or via the emergency department. The study involved cross-sectional analysis of information elicited through personal interview and prospective follow-up. The setting was a 450-bed public teaching hospital primarily serving a low-income area of Barcelona, Catalonia, Spain. Two hundred and forty-eight symptomatic patients were studied, who had cancer of the oesophagus (n = 31), stomach (n = 70), colon (n = 82) and rectum (n = 65). The main outcome measures were stage, type and intention of treatment and time elapsed from admission to surgery; the relative risk of death was calculated using Cox's regression. There were 161 (65%) patients admitted via the emergency department and 87 (35%) electively. The type of physician seen at the first pre-hospital visit had more often been a general practitioner in the emergency than in the elective group (89% vs 75%, P < 0.01). Emergency patients had seen a lower number of physicians from symptom onset until admission, but two-thirds had made repeated visits to a primary care physician. Emergency patients were less likely to have a localized tumour and a diagnosis of cancer at admission, and surgery as the initial treatment. Median survival was 30 months for elective patients and 8 months for emergency patients (P < 0.001), and the relative risk of death (RR) was 1.83 (95% confidence interval, CI, 1.32-2.54). After adjustment for strong prognostic factors, emergency patients continued to experience a significant excess risk (RR = 1.58; CI 1.10-2.27). In conclusion, in digestive tract cancers, admission to hospital via the emergency department is a clinically important marker of a poorer prognosis. Emergency departments can only partly counterbalance deficiencies in the effectiveness of and integration among the different levels of the health system. | - |
dc.format.extent | 8 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Cancer Research UK | - |
dc.relation.isformatof | Versió postprint del document publicat a: https://www.nature.com/bjc/volumes/77/issues/3 | - |
dc.relation.ispartof | British Journal of Cancer, 1998, vol. 77, num. 3, p. 477-484 | - |
dc.rights | (c) Porta, Miquel et al., 1998 | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Càncer gastrointestinal | - |
dc.subject.classification | Diagnòstic | - |
dc.subject.classification | Símptomes | - |
dc.subject.other | Gastrointestinal cancer | - |
dc.subject.other | Diagnosis | - |
dc.subject.other | Symptoms | - |
dc.title | Emergency admission for cancer: a matter of survival? | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/acceptedVersion | - |
dc.identifier.idgrec | 613775 | - |
dc.date.updated | 2019-12-18T18:06:17Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 9472647 | - |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) |
Files in This Item:
File | Description | Size | Format | |
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613775.pdf | 1.56 MB | Adobe PDF | View/Open |
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