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.
Original language | English (US) |
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Pages (from-to) | 286-292 |
Number of pages | 7 |
Journal | American Journal of Surgery |
Volume | 216 |
Issue number | 2 |
DOIs | |
State | Published - Aug 2018 |
Keywords
- Cancer diagnosis
- Emergency department
- Gastric cancer
ASJC Scopus subject areas
- Surgery