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  • Gunnarsson, H (författare)

Heterogeneity of colon cancer patients reported as emergencies

  • Artikel/kapitelEngelska2014

Förlag, utgivningsår, omfång ...

  • 2014-01-22
  • Springer Science and Business Media LLC,2014
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-230472
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-230472URI
  • https://doi.org/10.1007/s00268-014-2449-7DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:129557390URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND:Up to one-fourth of all colon cancer patients are reported as emergencies, and the aim of the present study was to scrutinize mode of presentation in this group.MATERIALS AND METHODS:All reported cases of emergency (n = 263) and randomly selected elective controls (1:2) of colon cancer in four Swedish counties 2006-2008 were eligible (n = 854). Symptoms and aspects of management were retrieved from surgery and primary care records. Outcomes were compared using Kaplan-Meier estimates and Cox regression.RESULTS:Among patients reported as emergencies, 158/263 (60 %) underwent operation within three days (acute), and 105 (40 %) after more than 3 days (subacute). In the latter group, 20/94 (21 %) had reported two symptoms, and 31/94 (33 %) had reported three or more symptoms associated with colon cancer to primary care during the last 12 months prior to surgery. In total, 46/105 (44 %) had already had an examination of the large bowel, and 52/105 (50 %) were stage IV, as opposed to 36/158 (23 %) in the acute group and 83/577 (15 %) in the elective group (p < 0.001). Mortality at 30 and 90 days was 15.2 and 35.6 % in the subacute group, 8.2 and 14.9 % in the acute group (p = 0.001), and 1.9 and 4.3 % in the elective group (p < 0.001); 5-year survival was 28.3, 40.1, and 57.8 %, respectively, in the three groups (p < 0.001). The hazard ratio, adjusted for age, sex, and stage, was 1.88 95 % confidence interval (CI) 1.5-2.4) for the acute group and 2.29 (95 % CI 1.7-3.1) for the subacute group.CONCLUSIONS:Colon cancer patients reported as emergencies but operated upon more than three days after admission had the worst outcome. Efforts to decrease the interval between admission and surgery is one important aspect of care, but wider attention must also be paid to this group of patients.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Jennische, K (författare)
  • Forssell, S (författare)
  • Granström, J (författare)
  • Jestin, PiaUppsala universitet,Kolorektalkirurgi(Swepub:uu)pijes226 (författare)
  • Ekholm, AUppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD) (författare)
  • Olsson, L IKarolinska Institutet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD) (författare)
  • Uppsala universitetKolorektalkirurgi (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:World Journal of Surgery: Springer Science and Business Media LLC38:7, s. 1819-18260364-23131432-2323

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