Emergency management of patients with colorectal cancer
Notice bibliographique
Résumé
Background: According to the literature, up to 30% patients with colorectal cancers (CRCs) present to the emergency department (ED) with surgical emergencies. The most common surgical presentations of these patients are: intestinal obstruction, perforation and bleeding. Palliative surgical interventions in these patients are believed to carry high risks of morbidity and mortality. Moreover, management options tend to be individualized in most cases, if not all. Methodology: A systematic review of published literature was conducted. Articles meeting inclusion criteria were summarized. Quantitative data regarding study characteristics were analyzed and expressed as descriptive statistics. Primary outcomes of interest were post-operative complications, mortality and 5-year disease free status. Results: 304 articles were collected from searching online data bases. Eight articles were found to match the research question and underwent a full text review. Five more articles were added from searching the grey literature. After final review, 11 articles were selected to be included in the systematic review. Papers were assessed for methodological validity. 81.8% of studies used regression models in their analyses. Mean number of patients included in the papers was 3,567 (min= 145, max= 30,790). 50.2% of all patients were males. Most of the included studies reported mean age of more than 60 years. The mean follow-up period in days was 399.5. Analysis of different variables revealed that, CRC patients who received emergency surgery had more comorbidities (95% CI, OR=1.42 P=0.05), higher American Society of Anesthesiology classes (95% CI, OR=1.33 P=0.08), and more advanced disease (95% CI, OR=1.09 P=0.02) than CRC patients who receive surgical intervention on elective basis. Moreover, resection rate was higher in the elective group (95% CI, OR=0.5 P=0.04). In contrast, stoma creation rate was higher in the emergency group (95% CI, OR=5.08 P=0.003). Furthermore, emergency patients had higher rates of postoperative complications (95% CI, OR=4.6 P=0.007) and mortality (95% CI, OR=5.38 P=0.0001). Conclusion: Patients requiring emergency surgery for CRC often have complex comorbidities and acute instability, and are at very high risk of postoperative complications. These findings highlight an important opportunity for the development of comprehensive systems of emergency surgical care, and, ultimately, improvement of patient outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».