Attributes of cancer patients admitted to the emergency department in one year.

BACKGROUND: Cancer patients frequently visit the emergency department (ED) with various symptoms of cancer. The purpose of this study was to determine the clinical characteristics and 1-year survival rate of cancer patients in the ED of a university hospital. METHODS: We conducted a retrospective review of 408 cancer patients who visited the ED between January 2011 and December 2011. Patient information on demographics, chief complaints, findings, and survival was gathered from the hospital registry and corresponding health administration. RESULTS: The study included 240 (58.8%) males and 168 (41.2%) females with a median age of 57.9 years (range 19-87). Regarding cancer staging, 266 patients (65.3%) had metastatic disease and 142 (34.7%) had local and loco-regional disease. The hospitalization rate was 59.6%. The most common symptoms were shortness of breath (23.2%), pain (17.8%), fever (14.2%), and nausea/vomiting (14.4%). The most common cancer sites were the lung (32.5%), gastrointestinal system (25.4%), and breast (9.3%). The initial evaluation determined progressive disease (42.4%), chemotherapy effects (20.7%), infections (17.2%), radiotherapy effects (4.7%), extravasation (1.8%), anemia (1.4%), and unknown (11.3%). During follow up, 191 (46.8%) patients died after admission to the ED. The 1-year overall survival of all patients was 7.3 months. CONCLUSIONS: Symptom management in cancer patients is a complex multifaceted concern for the emergency physician. Because of the increasing prevalence of cancer patients, emergency physicians should develop consensus algorithms in collaboration with the relevant disciplines to manage the commonly encountered problems.

Rapidly progressing malignant insulinoma presented with multiple liver metastases: a case report.

INTRODUCTION: A 51-year-old female was admitted to emergency unit with sudden loss of consciousness. Her blood glucose level from fingertip was 33 mg/dl, and insulin level was 55 (normal range, 4-17 IU). Abdominal ultrasonography revealed pancreatic mass with diffuse liver metastases. Biopsy of liver metastases showed differentiated neuroendocrine carcinoma. METHODS AND RESULTS: Diazoxide and chemotherapy stabilized her glucose level for more than 4 months. However, the disease showed progression, and death occurred 8 months later. CONCLUSION: In conclusion, this case may suggest that biologic behavior may differ from histological behavior in insulinoma and platin-based systemic chemotherapy may provide some benefit in patients those who had diazoxide- and octreotide-resistant tumors.

Attributes of cancer patients admitted to the emergency department in one year / 世界急诊医学杂志（英文）

@#BACKGROUND:Cancer patients frequently visit the emergency department (ED) with various symptoms of cancer. The purpose of this study was to determine the clinical characteristics and 1-year survival rate of cancer patients in the ED of a university hospital. METHODS:We conducted a retrospective review of 408 cancer patients who visited the ED between January 2011 and December 2011. Patient information on demographics, chief complaints, findings, and survival was gathered from the hospital registry and corresponding health administration. RESULTS:The study included 240 (58.8％) males and 168 (41.2％) females with a median age of 57.9 years (range 19–87). Regarding cancer staging, 266 patients (65.3％) had metastatic disease and 142 (34.7％) had local and loco-regional disease. The hospitalization rate was 59.6％. The most common symptoms were shortness of breath (23.2％), pain (17.8％), fever (14.2％), and nausea/vomiting (14.4％). The most common cancer sites were the lung (32.5％), gastrointestinal system (25.4％), and breast (9.3％). The initial evaluation determined progressive disease (42.4％), chemotherapy effects (20.7％), infections (17.2％), radiotherapy effects (4.7％), extravasation (1.8％), anemia (1.4％), and unknown (11.3％). During follow up, 191 (46.8％) patients died after admission to the ED. The 1-year overallsurvival of allpatients was 7.3 months. CONCLUSIONS:Symptom management in cancer patients is a complex multifaceted concern for the emergency physician. Because of the increasing prevalence of cancer patients, emergency physicians should develop consensus algorithms in collaboration with the relevant disciplines to manage the commonly encountered problems.

Imipenem-cilastatin versus sulbactam-cefoperazone plus amikacin in the initial treatment of febrile neutropenic cancer patients

The treatment of infectious complications in cancer patients has evolved as a consequence of the developments in the chemotherapy of cancer patients. In this prospective, randomized study, we compared imipenem-cilastatin and sulbactam-cefoperazone with amikacin in the empiric therapy of febrile neutropenic ( 0.05). No major adverse effects occurred. This study demonstrated that imipenem-cilastatin monotherapy and combination therapy of sulbactam-cefoperazone plus amikacin were equally effective empiric therapy for febrile granulocytopenic cancer patients.