Head & neck · 2019
Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective.
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Kligerman Maxwell P, Sethi Rosh K V, Kozin Elliott D, Gray Stacey T, Shrime Mark G
Аннотация
BACKGROUND: Emergency departments are playing an increasing role in cancer management. Emergency department utilization by patients with head and neck cancer, however, is unknown.
METHODS: The 2009-2011 Nationwide Emergency Department Sample was queried for patients with a principle diagnosis of head and neck cancer. Descriptive analysis was performed to characterize patient and hospital characteristics, outcomes, and charges. Logistic regression identified predictors of admission and mortality.
RESULTS: A total of 31 390 patients were seen in the emergency department with head and neck cancer: 72.8% were admitted, 0.5% died in the emergency department, and 5.0% died during admission. Patients with cancer of unknown primary site had the greatest odds of admission (odds ration [OR]: 2.83; P < 0.0001). Privately insured patients (OR: 1.78; P = 0.001), those from higher income zip codes (OR: 1.56; P = 0.008), and those with oropharyngeal cancer (OR: 2.02; P = 0.0003) had the greatest odds of death.
CONCLUSION: These findings have direct implications for preventing unnecessary and costly emergency department visits, improving hospital and physician preparedness, and improving patient outcomes.
METHODS: The 2009-2011 Nationwide Emergency Department Sample was queried for patients with a principle diagnosis of head and neck cancer. Descriptive analysis was performed to characterize patient and hospital characteristics, outcomes, and charges. Logistic regression identified predictors of admission and mortality.
RESULTS: A total of 31 390 patients were seen in the emergency department with head and neck cancer: 72.8% were admitted, 0.5% died in the emergency department, and 5.0% died during admission. Patients with cancer of unknown primary site had the greatest odds of admission (odds ration [OR]: 2.83; P < 0.0001). Privately insured patients (OR: 1.78; P = 0.001), those from higher income zip codes (OR: 1.56; P = 0.008), and those with oropharyngeal cancer (OR: 2.02; P = 0.0003) had the greatest odds of death.
CONCLUSION: These findings have direct implications for preventing unnecessary and costly emergency department visits, improving hospital and physician preparedness, and improving patient outcomes.
Предметные рубрики MeSH
AdultAgedCause of DeathDatabases, FactualEmergency Service, HospitalFemaleHead and Neck NeoplasmsHospital CostsHospital MortalityHospitalizationHumansIncidenceInsurance CoverageLength of StayLogistic ModelsMaleMiddle AgedMorbidityRetrospective StudiesRisk AssessmentSquamous Cell Carcinoma of Head and NeckUnited States