Clinical and epidemiological characteristics of patients with end-stage chronic disease who were admitted in an emergency department

• Autores: Amado-Tineo, Jose, Vásquez-Alva, Rolando, Huari-Pastrana, Roberto, Villavicencio-Chávez, Christian, Rimache-Inca, Liliana, Lizonde-Alejandro, Rosa, Oscanoa-Espinoza, Teodoro
• Formato: artículo
• Fecha de Publicación: 2020
• Institución: Universidad Nacional Mayor de San Marcos
• Repositorio: Revistas - Universidad Nacional Mayor de San Marcos
• Lenguaje: español
• OAI Identifier: oai:ojs.csi.unmsm:article/16848
• Enlace del recurso: https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/16848
• Nivel de acceso: acceso abierto
• Materia: Servicios Médicos de Urgencia; Cuidado Terminal; Cuidados Paliativos; Enfermedad Crónica; Emergency Medical Department; Terminal Care; Palliative Care; Chronic Disease

Introduction. Patients with advanced chronic disease (cancer and non-cancer) often go to emergency services. Objectives. To determine terminal chronic disease in those admitted to emergency, reason for admission, treatment and destination, comparing cancer with non-cancer. Methods. Observational study in people over 18 year old admitted to the emergency department of a tertiary hospital. Instrument: Supportive and Palliative Care Indicators Tool. Statistical analysis: Chi-square and U Mann-Whitney tests, considering p <0.05. Results. Of 4925 admissions, 271 (5,5%) met criteria. 233 patients were analyzed, median age 77 years [28-99], female sex 59%. Cancer diagnosis 42%, dementia 23%, neurological sequelae 15%, liver cirrhosis 12% and another 8%. Reason for admission was 48% infection, 9% uncontrolled pain and 7% bleeding. Antibiotics were used in 48% of patients, opioids 12% (morphine and tramadol) and transfusions 9%; 8.6% of these patients received advanced life support (mechanical ventilation 5,6%, inotropic 4,7% and hemodialysis 0,8%). The median stay in the emergency room was 6 days [1-62]; 27% died, 32% were discharged and 42% were referred to another hospital department. The stay and reason for admission were similar in cancer and non-cancer (p>0,05), presenting older age and disease time in non-cancer patients (p<0,01). Conclusions. One of every 20 admissions to the emergency department evaluated corresponds to a chronic disease in the terminal phase (more frequent non-cancer), being the reasons for admission infections, pain and bleeding.