Affiliation:
1. University Department of Surgery, Hope Hospital, Salford, UK
2. Department of Clinical Studies, Trafford General Hospital, Manchester, UK
Abstract
Abstract
Of 905 patients with colorectal cancer admitted to a single district general hospital, 272 (30 per cent) were admitted as emergencies. Emergency patients had more advanced tumours (Dukes stage B and C 96 per cent versus 88 per cent of those admitted electively, P < 0·006), a shorter history (median 3 versus 11 weeks, P < 0·001), were less likely to be fully ambulatory (44 versus 80 per cent, P < 0·0001) and more likely to have abdominal pain (74 versus 51 per cent, P < 0·001) and vomiting (40 versus 10 per cent, P <0·0001). More emergency patients were given stomas (56 versus 35 per cent, P < 0·0001) and died in hospital (19 versus 8 per cent, P < 0·0001). Of those who survived to be discharged, patients admitted as an emergency spent longer in hospital (median stay 16 versus 13 days, P <0·0001) and had a poorer overall 5-year survival rate (29 versus 39 per cent, P = 0·0001). Emergency patients were significantly older (median 74 versus 72 years, P = 0·04) and much more likely to be widowed (41 versus 27 per cent, P = 0·0002) than those admitted for elective surgery. If the personal and resource disaster of emergency colorectal cancer admission is to be reduced, screening strategies targeted by demographic characteristics require investigation.
Publisher
Oxford University Press (OUP)
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