Doentes oncológicos utilizadores frequentes do serviço de urgência: Principais características demográficas e clínicas

Carlos Daniel Macedo Ferreira; Francisco Nuno Rocha Gonçalves; Filipe Miguel Soares Pereira

Carlos Daniel Macedo Ferreira Cooperativa de Ensino Superior Politécnico e Universitário, Escola Superior de Enfermagem do Tâmega e Sousa, Penafiel, Portugal; Unidade de Investigação para a Inovação em Saúde e Bem-Estar – Research Unit (iHealth4Well-being), Instituto Politécnico de Saúde do Norte, CESPU (Penafiel, Portugal) https://orcid.org/0000-0002-9822-2757
Francisco Nuno Rocha Gonçalves Faculdade de Medicina da Universidade do Porto (Porto, Portugal) https://orcid.org/0000-0002-9033-9440
Filipe Miguel Soares Pereira Escola Superior de Enfermagem do Porto, Porto, Portugal; Centro de Investigação Desenvolvimento em Sistemas de Informação em Enfermagem (CIDESI), Escola Superior de Enfermagem do Porto (Porto, Portugal) https://orcid.org/0000-0002-3480-6243

Palabras clave: Gestión de casos, Neoplasias, Pacientes con cáncer, Servicio de urgencias hospitalario, Uso del servicio de urgencias, Sobremedicalización

Key-words: Case management, Neoplasms, Cancer patient, Emergency service hospital, Emergency room visits, Medical overuse

Palavras chave: Gestão de casos, Neoplasias, Doentes com cancro, Serviço hospitalar de emergência, Utilização do serviço de urgência, Sobremedicalização

Resumen

Marco contextual: Los pacientes con cáncer suelen acudir con frecuencia a los servicios de urgencias (SU) y pueden tener más episodios de hospitalización no programada. Algunos episodios podrían evitarse con programas de seguimiento adecuados. Objetivo: Identificar las características de sexo, edad y enfermedad de los pacientes que acuden con más frecuencia a urgencias en una institución especializada en el tratamiento del cáncer. Metodología: Estudio de cohorte retrospectivo de pacientes adultos de una institución especializada en el tratamiento del cáncer, mediante el análisis de las variables edad, sexo, características de la enfermedad y utilización de recursos en las historias clínicas de tres grupos con diferentes intensidades de acceso al SU. Resultados: Los pacientes que más acudieron a urgencias suelen ser tratados con quimioterapia, y los cánceres diagnosticados con más frecuencia son los del sistema hematopoyético y reticuloendotelial, y de los ganglios linfáticos, con invasión ganglionar o metástasis. La edad y el sexo no implica que se recurra más a urgencias. Conclusión: Identificar el perfil de estos pacientes permite elaborar programas de seguimiento más detallados para intentar reducir las visitas a urgencias y las hospitalizaciones no programadas

Abstract

Background: Patients with cancer often use emergency services more frequently and may experience more unplanned hospitalizations. If follow-up programs are implemented appropriately, certain instances can be avoided. Objective: To determine the age, gender, and disease-related characteristics of the patients who visit the emergency room of an institution specialized in cancer treatment the most frequently. Methodology: A retrospective cohort study was conducted on adult patients from an institution specialized in cancer treatment. The study involved the analysis of clinical records pertaining to age, gender, disease characteristics, and use of resources across three groups with varying levels of emergency room visits. Results: Patients with more emergency room visits are often treated with chemotherapy, and the most commonly diagnosed cancers are of the hematopoietic and reticuloendothelial systems and lymph nodes, with lymph node invasion or metastasis. The greater use of the ER is not explained by age or gender. Conclusion: Identifying the profile of these patients allows for more detailed follow-up programs to reduce emergency room visits and unplanned hospitalizations

Resumo

Enquadramento: Os doentes oncológicos tendem a tornar-se utilizadores frequentes dos serviços de urgência (SU), podendo ter mais episódios de internamento não programados. Alguns episódios poderão ser evitados com programas de acompanhamento adequados. Objetivo: Identificar características relativamente ao sexo, idade e doença, dos doentes que mais vezes acedem ao SU, numa instituição especializada no tratamento de cancro. Metodologia: Estudo de coorte retrospetivo de doentes adultos de uma instituição especializada no tratamento oncológico, através da análise dos registos clínicos das variáveis idade, sexo, características da doença e utilização de recursos, em três grupos com diferentes intensidades de acesso ao SU. Resultados: Doentes com mais acessos ao SU são frequentemente tratados com quimioterapia, os cancros mais diagnosticados são dos sistemas hematopoiético e reticuloendotelial, e gânglios linfáticos, com invasão de gânglios ou metastização. A maior utilização do SU não é explicada pela idade ou sexo. Conclusão: A identificação do perfil destes doentes possibilita maior detalhe na construção de programas de acompanhamento, na tentativa de diminuição dos acessos ao SU e internamentos não programados

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Doentes oncológicos utilizadores frequentes do serviço de urgência: Principais características demográficas e clínicas

Patients with cancer who frequently use the emergency department: Main demographic and clinical characteristics

Pacientes oncológicos usuarios frecuentes de los servicios de urgencias: Principales características demográficas y clínicas

Resumen

Abstract

Resumo

Bibliografía