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EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study

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Department of Emergency Medicine, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, 1 avenue Claude Vellefaux, 75010 Paris, France
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Department of Emergency Medicine, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, 92100 Boulogne-Billancourt, France
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INSERM UMRS 1144, Paris-Descartes University, 75006 Paris, France
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Initiatives de Recherche aux Urgences (IRU) Research Network, Société Française de Médecine d’Urgence (SFMU), 75010 Paris, France
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Department of Emergency Medicine & Critical Care, Besançon University Hospital, 25000 Besançon, France
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Department of Emergency Medicine, SMUR, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France
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Faculty of Medicine, Paris Diderot University, 75010 Paris, France
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Department of Emergency Medicine, Toulouse University Hospital, 31059 Toulouse, France
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Faculty of Medicine, Toulouse III—Paul Sabatier University, 31330 Toulouse, France
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Department of Emergency Medicine, SAMU 33, Pellegrin University Hospital, 33000 Bordeaux, France
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Department of Emergency Medicine, SAMU 68, Mulhouse Hospital, 68100 Mulhouse, France
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Department of Emergency Medicine, Colmar Hospital, 68000 Colmar, France
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Department of Emergency Medicine, Rouen University Hospital, F-76031 Rouen, France
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Department of Emergency Médicine, Jean Bernard Hospital, 59322 Valenciennes, France
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Department of Emergency Medicine, Annecy Genevois Hospital, 74370 Annecy, France
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Department of Emergency Medicine, SAMU 95, René Dubos Hospital, 95300 Pontoise, France
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Intensive Care Unit, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France
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Centre of Research in Epidemiology and StatisticS (CRESS), INSERM, UMR 1153, Epidemiology and Clinical Statistics for Tumor, Respiratory, and Resuscitation Assessments (ECSTRRA) Team. University of Paris, 75010 Paris, France
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Department of Biostatistics and Medical Information, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, 75004 Paris, France
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Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(5), 1505; https://doi.org/10.3390/jcm9051505
Received: 28 April 2020 / Revised: 12 May 2020 / Accepted: 14 May 2020 / Published: 17 May 2020
(This article belongs to the Section Emergency Medicine)
Background: We aimed to estimate the prevalence of cancer patients who presented to Emergency Departments (EDs), report their chief complaint and identify the predictors of 30-day all-cause mortality. Patients and methods: we undertook a prospective, cross-sectional study during three consecutive days in 138 EDs and performed a logistic regression to identify the predictors of 30-day mortality in hospitalized patients. Results: A total of 1380 cancer patients were included. The prevalence of cancer patients among ED patients was 2.8%. The most frequent reasons patients sought ED care were fatigue (16.6%), dyspnea (16.3%), gastro-intestinal disorders (15.1%), trauma (13.0%), fever (12.5%) and neurological disorders (12.5%). Patients were admitted to the hospital in 64.9% of cases, of which 13.4% died at day 30. Variables independently associated with a higher mortality at day 30 were male gender (Odds Ratio (OR), 1.63; 95% CI, 1.04–2.56), fatigue (OR, 1.65; 95% CI, 1.01–2.67), poor performance status (OR, 3.00; 95% CI, 1.87–4.80), solid malignancy (OR, 3.05; 95% CI, 1.26–7.40), uncontrolled malignancy (OR, 2.27; 95% CI, 1.36–3.80), ED attendance for a neurological disorder (OR, 2.38; 95% CI, 1.36–4.19), high shock-index (OR, 1.80; 95% CI, 1.03–3.13) and oxygen therapy (OR, 2.68; 95% CI, 1.68–4.29). Conclusion: Cancer patients showed heterogeneity among their reasons for ED attendance and a high need for hospitalization and case fatality. Malignancy and general health status played a major role in the patient outcomes. This study suggests that the emergency care of cancer patients may be complex. Thus, studies to assess the impact of a dedicated oncology curriculum for ED physicians are warranted. View Full-Text
Keywords: cancer; emergency department; epidemiology cancer; emergency department; epidemiology
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Peyrony, O.; Fontaine, J.-P.; Beaune, S.; Khoury, A.; Truchot, J.; Balen, F.; Vally, R.; Schmitt, J.; Ben Hammouda, K.; Roussel, M.; Borzymowski, C.; Vallot, C.; Sanh, V.; Azoulay, E.; Chevret, S. EPICANCER—Cancer Patients Presenting to the Emergency Departments in France: A Prospective Nationwide Study. J. Clin. Med. 2020, 9, 1505.

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