通过急诊科就诊的肺癌患者的特征和治疗效果:怀卡托地区卫生局的一项研究。

IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-27 DOI:10.26635/6965.6481
Ross Lawrenson, Chunhuan Lao, Ha Nguyen, Lucia Moosa, Rawiri Keenan, George Laking, Janice Wong, Mark Elwood
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引用次数: 0

摘要

目的:本研究探讨了在新西兰怀卡托医院急诊科(ED)就诊后确诊为肺癌的患者的特征和生存结果:这项回顾性研究以2011年至2021年期间记录在米德兰肺癌登记册上的怀卡托患者综合数据库为基础。我们比较了肺癌确诊前 14 天内急诊就诊和未急诊就诊患者的特征。我们还比较了毛利人和非毛利人在急诊室就诊和未就诊患者的存活率。该研究还根据逻辑回归分析了确诊前通过急诊室就诊和存活12个月的几率比(OR):研究共纳入2397名患者,其中39.6%的患者在确诊前曾在急诊室就诊。毛利人在就诊急诊室后被确诊的几率是非毛利人的1.27倍。患者的其他特征包括:男性、被诊断为小细胞肺癌以及病情处于晚期。与未到急诊室就诊的患者相比,到急诊室就诊的患者存活12个月的可能性较低(OR值为0.42),而到急诊室就诊两次或两次以上的患者存活12个月的可能性更低(OR值为0.33):结论:通过急诊科就诊的患者多为晚期患者,而通过全科医生(GP)就诊的患者则有证据表明能更早得到诊断,存活率更高。需要对通过全科医生就诊进行早期诊断的障碍进行探讨,尤其是对毛利人和男性而言。
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Characteristics and outcomes of lung cancer patients presenting through the emergency department: a Waikato District Health Board study.

Aim: This research examines the characteristics and survival outcomes of patients receiving a lung cancer diagnosis after attending the emergency department (ED) of Waikato hospitals in New Zealand.

Methods: This retrospective study was based on a comprehensive database of Waikato patients recorded on the Midland Lung Cancer Register from 2011 to 2021. We compared the characteristics of patients with and without emergency presentations within 14 days before their lung cancer diagnosis. The survival of patients with and without ED attendance was compared between Māori and non-Māori. This study also analysed the odds ratios (OR) of presenting via ED before diagnosis and surviving 12 months based on logistic regressions.

Results: In total, 2,397 patients were included, with 39.6% attending the ED prior to diagnosis. Māori were 1.27 times more likely than non-Māori to be diagnosed after attending the ED. Other characteristics of patients included being male, being diagnosed with small cell lung cancer and having more advanced-stage disease. Patients attending the ED were less likely to survive 12 months than those without ED visits (OR 0.42), and those with two or more ED visits were even less likely to survive 12 months (OR 0.33).

Conclusion: Patients presenting through the ED have more advanced-stage disease, while those presenting through their general practitioners (GPs) have evidence of being diagnosed earlier and having better survival. Barriers to early diagnoses through attendance with a GP, particularly for Māori and for men, need to be explored.

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来源期刊
NEW ZEALAND MEDICAL JOURNAL
NEW ZEALAND MEDICAL JOURNAL MEDICINE, GENERAL & INTERNAL-
CiteScore
2.30
自引率
23.50%
发文量
229
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