학술논문
Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department.
Document Type
Article
Author
Yilmaz, Sule; Grudzen, Corita R.; Durham, Danielle D.; McNaughton, Caroline; Marcelin, Isabelle; Abar, Beau; Adler, David; Bastani, Aveh; Baugh, Christopher W.; Bernstein, Steven L.; Bischof, Jason J.; Coyne, Christopher J.; Henning, Daniel J.; Hudson, Matthew F.; Klotz, Adam; Lyman, Gary H.; Madsen, Troy E.; Pallin, Daniel J.; Reyes-Gibby, Cielito; Rico, Juan Felipe
Source
Subject
*TUMOR treatment
*HOSPITAL emergency services
*CONFIDENCE intervals
*SEVERITY of illness index
*TREATMENT effectiveness
*SURVEYS
*CANCER patients
*DESCRIPTIVE statistics
*ODDS ratio
*PALLIATIVE treatment
*MEDICAL needs assessment
*SECONDARY analysis
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Language
ISSN
1096-6218
Abstract
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. [ABSTRACT FROM AUTHOR]