BACKGROUND: Emergency room presentation (ERP) in colorectal cancer (CRC) is associated with worse cancer-related outcomes. The goal of this study was to determine the frequency of ERP and identify factors associated with ERP of CRC. METHODS: We performed a prospective consecutive cohort study of all patients undergoing resection for CRC from 02/2002 to 02/2004. Standardized data collection involved hospital record review, patient interview, and prospective follow-up. ERP was defined as the diagnosis and/or surgical treatment of CRC as a result of presentation to the emergency department. RESULTS: Of the 455 patients in the study 108 (24%) had ERP. Presentation of those with ERP was obstruction in 46 (43%), bleeding/anemia in 35 (32%), pain in 25 (23%), and other (2%). The ERP cohort was older (mean age 70.8 vs. 67.0 years, P = 0.005). ERP was more common amongst females (29.7 vs. 18.2%, P = 0.004) and obesity appears to be associated with increased rates of ERP. ERP of CRC was associated with more advanced TNM stage. The ERP cohort had longer length of stay in hospital (median 10 vs. 8 days respectively, P < 0.001). Peri-operative mortality was higher in ERP patients (7.4 vs. 2.3%, P = 0.03). CONCLUSIONS: ERP in CRC was not infrequent and appeared to be associated with female gender and weight. The known negative prognostic impact of ERP, combined with the increased peri-operative mortality and length of stay, would suggest a potential benefit to targeted strategies aimed at reducing the use of the emergency room in the diagnosis and treatment of CRC.
BACKGROUND: Emergency room presentation (ERP) in colorectal cancer (CRC) is associated with worse cancer-related outcomes. The goal of this study was to determine the frequency of ERP and identify factors associated with ERP of CRC. METHODS: We performed a prospective consecutive cohort study of all patients undergoing resection for CRC from 02/2002 to 02/2004. Standardized data collection involved hospital record review, patient interview, and prospective follow-up. ERP was defined as the diagnosis and/or surgical treatment of CRC as a result of presentation to the emergency department. RESULTS: Of the 455 patients in the study 108 (24%) had ERP. Presentation of those with ERP was obstruction in 46 (43%), bleeding/anemia in 35 (32%), pain in 25 (23%), and other (2%). The ERP cohort was older (mean age 70.8 vs. 67.0 years, P = 0.005). ERP was more common amongst females (29.7 vs. 18.2%, P = 0.004) and obesity appears to be associated with increased rates of ERP. ERP of CRC was associated with more advanced TNM stage. The ERP cohort had longer length of stay in hospital (median 10 vs. 8 days respectively, P < 0.001). Peri-operative mortality was higher in ERP patients (7.4 vs. 2.3%, P = 0.03). CONCLUSIONS: ERP in CRC was not infrequent and appeared to be associated with female gender and weight. The known negative prognostic impact of ERP, combined with the increased peri-operative mortality and length of stay, would suggest a potential benefit to targeted strategies aimed at reducing the use of the emergency room in the diagnosis and treatment of CRC.
Authors: Mark Corkum; Robin Urquhart; Cynthia Kendell; Fred Burge; Geoffrey Porter; Grace Johnston Journal: Cancer Causes Control Date: 2011-11-20 Impact factor: 2.506
Authors: David Weithorn; Vanessa Arientyl; Ian Solsky; Goyal Umadat; Rebecca Levine; Bruce Rapkin; Jason Leider; Haejin In Journal: J Surg Res Date: 2020-06-17 Impact factor: 2.192
Authors: Joyce V Veld; Kim J Beek; Esther C J Consten; Frank Ter Borg; Henderik L van Westreenen; Wilhelmus A Bemelman; Jeanin E van Hooft; Pieter J Tanis Journal: Colorectal Dis Date: 2021-01-15 Impact factor: 3.788
Authors: S McPhail; L Elliss-Brookes; J Shelton; A Ives; M Greenslade; S Vernon; E J A Morris; M Richards Journal: Br J Cancer Date: 2013-09-17 Impact factor: 7.640
Authors: Magdalena Esteva; Mercedes Ruidíaz; M Antonia Sánchez; Sonia Pértega; Salvador Pita-Fernández; Francesc Macià; Margarita Posso; Luis González-Luján; Marta M Boscá-Wats; Alfonso Leiva; Joana Ripoll Journal: PLoS One Date: 2018-10-01 Impact factor: 3.240