Emergency Presentations for Colorectal Cancer 2008-2013: Factors Associated with In-hospital Mortality
Yasmin Zerhouni, MD1, Nelya Melnitchouk, MD MSc1, Eric B. Schneider, PhD2
1Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA; 2Ohio State University Medical Center, Columbus, OH, USA
Background: Emergent presentations of colorectal cancer (CRC) have worse outcomes. We examined patient factors during emergent CRC care associated with in-hospital death and discharge to continuing care.
Methods: We queried the 2008–13 Nationwide Emergency Department Sample, a 20% stratified sample of United States (US) ED visits, and identified all visits with a primary ICD-9-CM diagnosis of CRC. Multivariable logistic regression was used to identify factors associated with in-hospital death or discharge to continuing care (skilled nursing facility, home health care).
Results: Of the approximately 265,236 ED visits made, 74.1% of patients were ≥60 years and 59.3% were Medicare beneficiaries. 89.4% of patients were admitted to the hospital. At discharge, 50.3% required continuing care. 5.6% died during the hospitalization. The average total charges were $82,144 and the average length of stay was 10.3 days. Factors associated with in-hospital death can be seen in Figure 1 while factors associated with discharge to continuing care can be seen in Figure 2.
Conclusion: ED visits for CRC consume substantial resources with nearly 90% of patients admitted to the hospital. Most of the patients (50.3%) require some form of additional care at discharge. Factors that increase risk of death or discharge to continuing care should inform patient care.
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