Gastric cancer diagnosis after presentation to the ED: The independent association of presenting location and outcomes

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Abstract

Background: The impact of diagnosis location on gastric cancer (GC) outcomes is poorly defined. Methods: Detailed chart review was conducted to identify presenting location leading to diagnosis and treatment for GC patients at a single institution (2009-2013). Patients treated non-emergently following a diagnosis prompted by an ED visit (EDdx) were compared with those diagnosed at other locations (non-EDdx). Results: EDdx patients comprised 52% of 263 GC patients. They were older, had later cancer stages (stage IV: 50% vs. 24%), more comorbidities (≥3: 68% vs. 47%), and presented with non-specific symptoms like bleeding (21% vs. 5%). Both groups were of similar race and insurance status. In a model adjusted for stage, EDdx was associated with increased mortality (aHR 1.9; 95% CI: 1.2-2.9). Conclusion: Half of GC patients had an ED visit prompting diagnosis, which is independently associated with increased mortality. Efforts should focus on reducing EDdx rates to improve GC outcomes. Summary: Demographics, treatment, and outcomes of gastric adenocarcinoma patients at a single center whose diagnosis was prompted by an emergency department (ED) visit were compared to that of patients diagnosed in non-ED settings. 52% of patients had an ED visit prompting their diagnosis, which was associated with an increased mortality risk.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jan 1 2017

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Keywords

  • Cancer diagnosis
  • Emergency department
  • Gastric cancer

ASJC Scopus subject areas

  • Surgery

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