Emergency presentations of head and neck cancer: a modern perspective

Bannister, Miles; Vallamkondu, Vamsidhar; Ah‐See, Kim

doi:10.1017/s0022215116001043

Cited by 13 publications

(14 citation statements)

References 17 publications

(13 reference statements)

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“…Patients with laryngeal cancer are more likely to develop emergent symptoms that affect their respiratory status, prompting emergency department visitation. Other subsites and associated complications of treatment are also more amenable to patient‐directed surveillance and outpatient management, whereas laryngeal cancer is difficult to monitor and treat without direct or indirect laryngoscopy …”

Section: Discussionmentioning

confidence: 99%

Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective

et al. 2019

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Background Emergency departments are playing an increasing role in cancer management. Emergency department utilization by patients with head and neck cancer, however, is unknown. Methods The 2009‐2011 Nationwide Emergency Department Sample was queried for patients with a principle diagnosis of head and neck cancer. Descriptive analysis was performed to characterize patient and hospital characteristics, outcomes, and charges. Logistic regression identified predictors of admission and mortality. Results A total of 31 390 patients were seen in the emergency department with head and neck cancer: 72.8% were admitted, 0.5% died in the emergency department, and 5.0% died during admission. Patients with cancer of unknown primary site had the greatest odds of admission (odds ration [OR]: 2.83; P < 0.0001). Privately insured patients (OR: 1.78; P = 0.001), those from higher income zip codes (OR: 1.56; P = 0.008), and those with oropharyngeal cancer (OR: 2.02; P = 0.0003) had the greatest odds of death. Conclusion These findings have direct implications for preventing unnecessary and costly emergency department visits, improving hospital and physician preparedness, and improving patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective

et al. 2019

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“…[2] With changing epidemiology, a study from the United Kingdom has noted that the oropharynx is the most common site among the patients presenting to ED. [6]…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the results of this study, dysphagia was the most common reason for reporting to the ED in the UK, whereas respiratory infections was the most common cause in North America. [46] This variation could be because of oropharyngeal and laryngeal cancer being the most common in those cohorts. A study from Taiwan too showed ill-defined complaints being the most common presentation of HNC patients coming to ED.…”

Section: Discussionmentioning

confidence: 99%

Emergency department visits by head-and-neck cancer patients

Malik

Sukumar

Pai

et al. 2019

Indian J Palliat Care

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Aim:This study was conducted to assess the disease status of head-and-neck cancer patients visiting the emergency department (ED) and their reason for presentation. We wanted to analyze if these visits could be avoided by incorporating any changes in our clinical practice.Methods:This was a retrospective analysis of head-and-neck cancer patients attending the ED at a tertiary care cancer center in 2017. Clinical details were noted from the electronic medical records, and descriptive statistics was calculated. The analysis was performed using SPSS version 21 software.Results:Three hundred and thirty-nine head-and-neck cancer patients attended the ED. Of these, 80.2% were males and 48.1% of patients had oral cavity cancers. About 37.2% required palliative care treatment. Nearly, 47.2% of patients presented during their initial evaluation period. About 22.7% required hospital admission and only 14.7% required any sort of emergency intervention.Conclusion:Majority of visits to ED could have been avoided with better counseling of the patients and their attendants.

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“…2 Bannister and colleagues' article from Scotland demonstrates an increase in emergency presentations of head and neck cancer cases, particularly oropharyngeal cancer, which is not easily explained at present. 3 There is certainly room for improvement in generating confidence among junior doctors in basic emergency skills in ENT, particularly in the accident and emergency department. 4 There is much folklore about what makes someone enter a particular specialty, the caricature cardiac surgeon being somewhat different from the caricature psychiatrist.…”

mentioning

confidence: 99%

“…One such idea is a well set up emergency clinic, which was covered in a recent article in relation to the importance of senior cover in such clinics 2 . Bannister and colleagues' article from Scotland demonstrates an increase in emergency presentations of head and neck cancer cases, particularly oropharyngeal cancer, which is not easily explained at present 3 . There is certainly room for improvement in generating confidence among junior doctors in basic emergency skills in ENT, particularly in the accident and emergency department 4 …”

mentioning

confidence: 99%

Service delivery: subspecialisation, emergencies, sharps injuries, personality traits and the ENT surgeon

Fisher¹,

Youngs²,

Hussain³

et al. 2016

J. Laryngol. Otol.

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Service delivery: subspecialisation, emergencies, sharps injuries, personality traits and the ENTsurgeonThere is a distinct flavour of psychology, organisational aspects of service delivery and what could be termed 'generalist interest' in this month's issue of The Journal of Laryngology & Otology. This allows us to take a broad perspective, and complements the more esoteric subject matter on offer in a journal such as ours. These generalist topics are too often neglected in our Continuing Professional Development as we strive to tick the boxes for revalidation in the specifics of our daily practice.Emergency cover in peripheral and large city ENT units continues to tax National Health Service trusts and rota organisers within departments and hospital groupings. ENT-UK has already addressed the matter of paediatric airway emergencies by providing tailored tuition, but is this just the tip of an iceberg of mismatched demand and skill mix? An analysis of the tension between subspecialisation and safe, effective emergency care won the 2014 ENT-UK undergraduate essay prize and is presented as a review, with several ideas for improving the current situation.1 One such idea is a well set up emergency clinic, which was covered in a recent article in relation to the importance of senior cover in such clinics.2 Bannister and colleagues' article from Scotland demonstrates an increase in emergency presentations of head and neck cancer cases, particularly oropharyngeal cancer, which is not easily explained at present.3 There is certainly room for improvement in generating confidence among junior doctors in basic emergency skills in ENT, particularly in the accident and emergency department. 4 There is much folklore about what makes someone enter a particular specialty, the caricature cardiac surgeon being somewhat different from the caricature psychiatrist. So where does the ENT surgeon fit in? A study by Vijendren et al. found a significantly higher proportion of type A personalities in ENT specialty trainees compared to foundation doctors, which would be true of surgeons in general; this personality type predisposes one to burnout in later career.5 Future studies on subspecialties of ENT, in a similar vein, might provide some interesting insights, but I doubt if many of us would be surprised by the findings! Whether personality type is responsible for a disappointingly low (one-third) reporting rate for sharps injuries in a paper by the same author 6 is debatable, but it seems that there are plenty of other reasons on offer to explain this, such as cumbersome reporting procedures.Incidental findings on radiology are a part of daily life in otolaryngology, and it is interesting to see a cohort of head and neck cancer patients followed up whose computed tomography (CT) findings showed pulmonary nodules, which is a problem shared by all specialties in which thoracic CT is requested regularly. Zammit-Maempel and coauthors found that only 7.4 per cent of benign looking nodules went on to become malignant, but that malignant no...

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Emergency presentations of head and neck cancer: a modern perspective

Abstract: Emergency presentations are increasing annually. Female patients and oropharyngeal cancer showed greater representation compared to male patients and laryngeal cancer.

Cited by 13 publications

References 17 publications

Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective

Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective

Emergency department visits by head-and-neck cancer patients

Service delivery: subspecialisation, emergencies, sharps injuries, personality traits and the ENT surgeon

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