6533b85dfe1ef96bd12bea7f

RESEARCH PRODUCT

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

subject

description

espanolObjeto: el objetivo del presente estudio es examinar la asociacion entre el tipo de admision hospitalaria, la supervivencia y las caracteristicas patologicas de una amplia poblacion de pacientes con cancer colorrectal. Metodos: realizamos un estudio en 1.079 pacientes diagnosticados en el Hospital Costa del Sol de Marbella con cancer colorrectal y evaluamos la relacion entre su tasa de supervivencia y la via por la que realizaron el primer contacto con el hospital (admision programada o de urgencias). Las variables incluidas en nuestro estudio fueron las siguientes: edad, genero, localizacion del tumor, estadio patologico, grado de diferenciacion, quimioterapia previa a la cirugia y supervivencia. Resultados: los pacientes admitidos por primera vez al hospital a traves del Servicio de Urgencias fueron diagnosticados con mayor frecuencia de cancer de colon (63,7%) y con tumores pobremente diferenciados (64,2%) y metastasicos (70%). En el analisis de regresion de Cox la supervivencia libre de enfermedad produjo una razon de riesgo (RR) de 1,36 (intervalo de confianza [IC] 95%: 1,11-1,66) para los pacientes del Servicio de Urgencias y para la supervivencia global de 1,41 (IC 95%: 1,14-1-76). Conclusiones: La admision hospitalaria a traves del Servicio de Urgencias es un indicador de agresividad y de peor pronostico frente a los pacientes que ingresan por via programada EnglishAims: 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.