A modified emergency severity index level is associated with outcomes in cancer patients with COVID-19.

Autor: Lipe DN; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: demis.ros@gmail.com., Bourenane SS; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Wattana MK; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Gaeta S; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Chaftari P; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Cruz Carreras MT; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Manzano JG; Department of Hospitalist Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Reyes-Gibby C; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: creyes@mdanderson.org.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2022 Apr; Vol. 54, pp. 111-116. Date of Electronic Publication: 2022 Feb 05.
DOI: 10.1016/j.ajem.2022.02.002
Abstrakt: Objective: To evaluate a modified emergency severity index (mESI)-based triage of cancer patients with coronavirus disease 2019 (COVID-19) in the emergency department (ED) and determine the associations between mESI level and ED disposition, hospital length of stay, and overall survival.
Methods: Medical records were retrospectively reviewed for all patients who presented to our institution's ED between March 22, 2020, and March 12, 2021, and tested positive for SARS-CoV-2.
Results: A total of 306 cancer patients tested positive for SARS-CoV-2, with 45% of patients triaged to level 2 (emergent) and 55% to level 3 (urgent). Among all patients, 61.8% were admitted to the hospital, 15.7% were admitted to the intensive care unit, 2.9% were sent for observation, and 19.6% were discharged. Although demographic and clinical characteristics did not significantly vary by triage level, we observed significant differences in ED length of stay (urgent = 6.67 h, emergent = 5.97 h; p < 0.01). Hospital and intensive care unit admission rates were also significantly higher among emergent patients than among urgent patients (p < 0.05). There were 75 deaths (urgent = 32; emergent = 43), and the 30-day mortality rate was significantly higher among emergent patients (urgent = 8%, emergent = 15%; p < 0.05). The mESI level persisted as a significant factor associated with overall survival (hazard ratio = 1.7, 95% confidence interval = 1.09-2.81) in multivariable analysis.
Conclusion: The mESI level is associated with ED disposition, ED length of stay, and overall survival in cancer patients presenting with COVID-19. These results indicate that the mESI triage tool can be effectively used in cancer patients with COVID-19, whose condition can rapidly deteriorate.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
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