| pubmed-article:9472647 | rdf:type | pubmed:Citation | lld:pubmed |
| pubmed-article:9472647 | lifeskim:mentions | umls-concept:C0006826 | lld:lifeskim |
| pubmed-article:9472647 | lifeskim:mentions | umls-concept:C0038952 | lld:lifeskim |
| pubmed-article:9472647 | lifeskim:mentions | umls-concept:C0175673 | lld:lifeskim |
| pubmed-article:9472647 | lifeskim:mentions | umls-concept:C0809949 | lld:lifeskim |
| pubmed-article:9472647 | pubmed:issue | 3 | lld:pubmed |
| pubmed-article:9472647 | pubmed:dateCreated | 1998-2-27 | lld:pubmed |
| pubmed-article:9472647 | pubmed:abstractText | 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. | lld:pubmed |
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| pubmed-article:9472647 | pubmed:language | eng | lld:pubmed |
| pubmed-article:9472647 | pubmed:journal | http://linkedlifedata.com/r... | lld:pubmed |
| pubmed-article:9472647 | pubmed:citationSubset | IM | lld:pubmed |
| pubmed-article:9472647 | pubmed:status | MEDLINE | lld:pubmed |
| pubmed-article:9472647 | pubmed:issn | 0007-0920 | lld:pubmed |
| pubmed-article:9472647 | pubmed:author | pubmed-author:PortaMM | lld:pubmed |
| pubmed-article:9472647 | pubmed:author | pubmed-author:FernandezEE | lld:pubmed |
| pubmed-article:9472647 | pubmed:author | pubmed-author:AlonsoJJ | lld:pubmed |
| pubmed-article:9472647 | pubmed:author | pubmed-author:MalatyHH | lld:pubmed |
| pubmed-article:9472647 | pubmed:author | pubmed-author:GallénMM | lld:pubmed |
| pubmed-article:9472647 | pubmed:author | pubmed-author:BellocJJ | lld:pubmed |
| pubmed-article:9472647 | pubmed:issnType | Print | lld:pubmed |
| pubmed-article:9472647 | pubmed:volume | 77 | lld:pubmed |
| pubmed-article:9472647 | pubmed:owner | NLM | lld:pubmed |
| pubmed-article:9472647 | pubmed:authorsComplete | Y | lld:pubmed |
| pubmed-article:9472647 | pubmed:pagination | 477-84 | lld:pubmed |
| pubmed-article:9472647 | pubmed:dateRevised | 2009-11-18 | lld:pubmed |
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| pubmed-article:9472647 | pubmed:year | 1998 | lld:pubmed |
| pubmed-article:9472647 | pubmed:articleTitle | Emergency admission for cancer: a matter of survival? | lld:pubmed |
| pubmed-article:9472647 | pubmed:affiliation | Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Spain. | lld:pubmed |
| pubmed-article:9472647 | pubmed:publicationType | Journal Article | lld:pubmed |
| pubmed-article:9472647 | pubmed:publicationType | Research Support, Non-U.S. Gov't | lld:pubmed |
| http://linkedlifedata.com/r... | pubmed:referesTo | pubmed-article:9472647 | lld:pubmed |
