Document Detail


Emergency department utilization can indicate early diagnosis of digestive tract cancers: A population-based study in Taiwan.
MedLine Citation:
PMID:  24835615     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Patients who visit emergency department (ED) may have symptoms of occult cancers.
METHODS: We studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cancers. The case group was digestive tract cancer patients and the control group was traumatic fracture patients. We reviewed record of ED visits only from 4 to 15 months before the cancer diagnoses.
RESULTS: There were 2635 and 6665 in the case and control groups respectively. Patients' adjusted odds ratio with 95% confidence interval for the case group were 1.36 (1.06-1.74) for Abdominal ultrasound, 2.16 (1.61-2.90) pan-endoscopy, 1.72 (1.33-2.22) guaiac fecal-occult blood test, 1.42 (1.28-1.58) plain abdominal X-rays, 1.20 (1.09-1.32) SGOT, 1.27 (1.14-1.40) SGPT, 1.66 (1.41-1.95) total bilirubin, 2.41 (1.89-3.08) direct bilirubin, 1.21 (1.01-1.46) hemoglobin and 3.63 (2.66-4.94) blood transfusion, respectively. Blood transfusion in the ED was a significant predictor of the individual subsequently diagnosed with digestive tract cancer.
CONCLUSIONS: The health system could identify high risk patients early by real-time review of their ED utilization before the diagnosis of digestive tract cancers. We proposed a follow-up methodology for daily screening of patients with high risk of digestive tract cancer by informatics system in the ED.
Authors:
Carlos Lam; Ching-Feng Kuan; James Miser; Kun-Yi Hsieh; Yu-Ann Fang; Yu-Chuan Li; Chin-Wang Hsu; Ray-Jade Chen; Chang-I Chen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-29
Journal Detail:
Title:  Computer methods and programs in biomedicine     Volume:  -     ISSN:  1872-7565     ISO Abbreviation:  Comput Methods Programs Biomed     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-5-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506513     Medline TA:  Comput Methods Programs Biomed     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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