An evolutionary role of the ED: outcomes of patients with colorectal cancers presenting to the ED were not compromised.

PURPOSE: Patients with colorectal cancer (CRC) who present to the emergency department (ED) reportedly have poorer prognoses than other referral sources. The purpose of this study was to compare the clinical presentations and outcomes of patients referred to the hospital from the ED and those referred from non-ED facilities.

METHODS

This retrospective medical record review study was conducted from January 1, 2008, to December 31, 2008, and comprised patients newly diagnosed as having CRC admitted to the hospital from the ED or referred from non-ED sources. Patients were admitted for CRC diagnosis confirmation, staging, and treatment. The staging at diagnosis and 2-year mortality were measured.

RESULTS

Forty-five (29.2%) patients comprised the ED group, and another 109 (70.8%) patients comprised the non-ED group. Patients in the ED group had significantly longer hospital stays, greater in-hospital mortality, abdominal pain, intestinal obstruction, complications, lower hemoglobin levels, and more proximal than rectosigmoid tumor locations compared with patients referred from other sources. However, there was no statistically significant difference in stage at diagnosis or 2-year mortality rate between the groups.

CONCLUSIONS

The ED played a pivotal role in the clinical and diagnostic evaluations of patients with CRC at our institution. Emergency department physicians provided timely diagnoses of CRC because the stage at diagnosis and 2-year mortality rate of ED patients were not compromised compared with that of patients referred from non-ED sources. Efforts should be made to reduce the numbers of patients with late presentations and acute complications associated with in-hospital mortality.