Patients with terminal chronic disease in the adult emergency service of a tertiary hospital
Introduction: Patients with chronic terminal disease frequently come to emergency department of reference hospitals. Objectives: To determine frequency of chronic terminal disease in patients admitted to emergency department, identify invasive procedures and compare oncological with non-oncological...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | Spanish |
| Published: |
Universidad Ricardo Palma
2019-06-01
|
| Series: | Revista de la Facultad de Medicina Humana |
| Subjects: | |
| Online Access: | http://revistas.urp.edu.pe/index.php/RFMH/article/view/2166 |
| _version_ | 1818139298547892224 |
|---|---|
| author | José Amado-Tineo Waldo Taype-Huamaní Rolando Vasquez-Alva Fiorella Siccha-Del Campo Teodoro Oscanoa-Espinoza |
| author_facet | José Amado-Tineo Waldo Taype-Huamaní Rolando Vasquez-Alva Fiorella Siccha-Del Campo Teodoro Oscanoa-Espinoza |
| author_sort | José Amado-Tineo |
| collection | DOAJ |
| description | Introduction: Patients with chronic terminal disease frequently come to emergency department of reference hospitals. Objectives: To determine frequency of chronic terminal disease in patients admitted to emergency department, identify invasive procedures and compare oncological with non-oncological patients. Methods: Cross-sectional study in patients older than 18 years old, admitted to emergency department of a tertiary hospital, November 2017. Criteria for terminal disease: Clinical stage IV cancer, severe cognitive deterioration or total functional dependence plus diagnosis of dementia, neurological sequelae, dependence of oxygen, glomerular filtration rate <30 ml / min, Child C cirrhosis, or left ventricular ejection fraction <20%. Statistical analysis with Mann-Whitney U and Chi square tests. Results:10.7% (172 of 1604 admissions) of admitted patients presented criteria of chronic terminal disease, with oncological cause 21.5% (37/172) and non-oncological 78.5% (135/172). In oncological patients, the median age was 70 years and was female 59.5%, while in non-oncological 84 years and 57% of women (p <0.01 and 0.79, respectively). 41% (71/172) were admitted by shock-trauma unit, more frequently due to drowsiness and dyspnea. Invasive procedures, probably unnecessary, were identified in 21.5% (37/172 patients), orotracheal intubation and central venous catheter for inotropic were the most frequent. The average stay in emergency department was eight days, with 32% of oncological deaths and 24% of non-oncological deaths in emergency department (p = 0.43). Conclusions: 10% of patients admitted to the emergency department of a tertiary hospital have chronic terminal disease, with a greater frequency of non-oncology, probably performing unnecessary procedures in one fifth of these. |
| first_indexed | 2024-12-11T10:25:52Z |
| format | Article |
| id | doaj.art-d35b115a61a44a99b25885ea30e4e046 |
| institution | Directory Open Access Journal |
| issn | 1814-5469 2308-0531 |
| language | Spanish |
| last_indexed | 2024-12-11T10:25:52Z |
| publishDate | 2019-06-01 |
| publisher | Universidad Ricardo Palma |
| record_format | Article |
| series | Revista de la Facultad de Medicina Humana |
| spelling | doaj.art-d35b115a61a44a99b25885ea30e4e0462022-12-22T01:11:11ZspaUniversidad Ricardo PalmaRevista de la Facultad de Medicina Humana1814-54692308-05312019-06-01193273410.25176/RFMH.v19i3.2166Patients with terminal chronic disease in the adult emergency service of a tertiary hospitalJosé Amado-Tineo0Waldo Taype-Huamaní1Rolando Vasquez-Alva2Fiorella Siccha-Del Campo3Teodoro Oscanoa-Espinoza4https://orcid.org/0000-0002-3286-4650 https://orcid.org/0000-0002-8559-2513https://orcid.org/0000-0001-6009-7113https://orcid.org/0000-0002-1677-9800 https://orcid.org/0000-0001-9379-4767Introduction: Patients with chronic terminal disease frequently come to emergency department of reference hospitals. Objectives: To determine frequency of chronic terminal disease in patients admitted to emergency department, identify invasive procedures and compare oncological with non-oncological patients. Methods: Cross-sectional study in patients older than 18 years old, admitted to emergency department of a tertiary hospital, November 2017. Criteria for terminal disease: Clinical stage IV cancer, severe cognitive deterioration or total functional dependence plus diagnosis of dementia, neurological sequelae, dependence of oxygen, glomerular filtration rate <30 ml / min, Child C cirrhosis, or left ventricular ejection fraction <20%. Statistical analysis with Mann-Whitney U and Chi square tests. Results:10.7% (172 of 1604 admissions) of admitted patients presented criteria of chronic terminal disease, with oncological cause 21.5% (37/172) and non-oncological 78.5% (135/172). In oncological patients, the median age was 70 years and was female 59.5%, while in non-oncological 84 years and 57% of women (p <0.01 and 0.79, respectively). 41% (71/172) were admitted by shock-trauma unit, more frequently due to drowsiness and dyspnea. Invasive procedures, probably unnecessary, were identified in 21.5% (37/172 patients), orotracheal intubation and central venous catheter for inotropic were the most frequent. The average stay in emergency department was eight days, with 32% of oncological deaths and 24% of non-oncological deaths in emergency department (p = 0.43). Conclusions: 10% of patients admitted to the emergency department of a tertiary hospital have chronic terminal disease, with a greater frequency of non-oncology, probably performing unnecessary procedures in one fifth of these.http://revistas.urp.edu.pe/index.php/RFMH/article/view/2166Chronic terminal diseaseAdmissionEmergency department |
| spellingShingle | José Amado-Tineo Waldo Taype-Huamaní Rolando Vasquez-Alva Fiorella Siccha-Del Campo Teodoro Oscanoa-Espinoza Patients with terminal chronic disease in the adult emergency service of a tertiary hospital Revista de la Facultad de Medicina Humana Chronic terminal disease Admission Emergency department |
| title | Patients with terminal chronic disease in the adult emergency service of a tertiary hospital |
| title_full | Patients with terminal chronic disease in the adult emergency service of a tertiary hospital |
| title_fullStr | Patients with terminal chronic disease in the adult emergency service of a tertiary hospital |
| title_full_unstemmed | Patients with terminal chronic disease in the adult emergency service of a tertiary hospital |
| title_short | Patients with terminal chronic disease in the adult emergency service of a tertiary hospital |
| title_sort | patients with terminal chronic disease in the adult emergency service of a tertiary hospital |
| topic | Chronic terminal disease Admission Emergency department |
| url | http://revistas.urp.edu.pe/index.php/RFMH/article/view/2166 |
| work_keys_str_mv | AT joseamadotineo patientswithterminalchronicdiseaseintheadultemergencyserviceofatertiaryhospital AT waldotaypehuamani patientswithterminalchronicdiseaseintheadultemergencyserviceofatertiaryhospital AT rolandovasquezalva patientswithterminalchronicdiseaseintheadultemergencyserviceofatertiaryhospital AT fiorellasicchadelcampo patientswithterminalchronicdiseaseintheadultemergencyserviceofatertiaryhospital AT teodorooscanoaespinoza patientswithterminalchronicdiseaseintheadultemergencyserviceofatertiaryhospital |