Supplementary materials: Patterns of emergency department visits preceding colorectal cancer diagnosis: a population-based study

These are peer-reviewed supplementary materials for the article 'Patterns of emergency department visits preceding colorectal cancer diagnosis: a population-based study' published in the Journal of Comparative Effectiveness Research.Supplementary figure 1Supplementary figure 2Supplementary tableAim: To assess the patterns of emergency department (ED) visits in the 3 months preceding a diagnosis of colorectal cancer (CRC) in a real-world, population-based context. Materials & methods: Linked provincial registries in Alberta, Canada, were accessed and patients with CRC diagnosed between 2004 and 2018 were identified. The National Ambulatory Care reporting system was used to identify patients who visited an ED within 3 months of a diagnosis of CRC. Multivariable logistic regression analysis was used to identify factors associated with any ED visits as well as frequent (≥3) ED visits. Results: A total of 25,310 patients with CRC were included in the current study. These include 10,126 patients (40%) who had at least one visit to the ED in the 3 months before a diagnosis of CRC diagnosis and 613 patients (2.4%) who visited the ED multiple (≥3) times. The following factors were associated with any visit to an ED: older age (odds ratio [OR]: 1.010; 95% CI: 1.008–1.012), female gender (OR: 1.23; 95% CI: 1.16–1.30), higher comorbidity index (OR: 1.38; 95% CI: 1.35–1.41), metastatic disease (OR: 2.37; 95% CI: 2.23–2.53), proximal tumors (OR: 1.59; 95% CI: 1.50–1.68) and North zone (OR vs south zone: 1.75; 95% CI: 1.55–1.98). Conclusion: It is not uncommon for CRC patients to visit the ED at least once in the 3 months prior to having such a diagnosis. Factors associated with frequent pre diagnosis emergency visits included female gender, higher burden of comorbid disease, advanced stage, proximal tumors and living in the North zone of Alberta (where there is limited access to specialist care).

本数据集为发表于《比较效果研究杂志》的论文《结直肠癌诊断前急诊科就诊模式：一项基于人群的研究》的同行评审补充材料。补充图1、补充图2、补充表。研究目的：评估在真实世界、基于人群的背景下，结直肠癌（CRC）诊断前三个月内急诊科（ED）就诊的模式。研究材料与方法：访问了加拿大艾伯塔省的省级登记系统，识别出2004年至2018年间被诊断为CRC的患者。利用国家门诊护理报告系统识别出在CRC诊断后三个月内访问过急诊科的患者。采用多变量逻辑回归分析以识别与任何急诊科就诊以及频繁（≥3次）急诊科就诊相关的因素。研究结果：当前研究共纳入25,310名CRC患者。其中，10,126名患者（占比40%）在CRC诊断前三个月内至少访问过一次急诊科，613名患者（占比2.4%）访问过急诊科多次（≥3次）。以下因素与急诊科就诊相关：年龄较大（比值比[OR]：1.010；95%置信区间[CI]：1.008–1.012）、女性性别（OR：1.23；95% CI：1.16–1.30）、较高的合并症指数（OR：1.38；95% CI：1.35–1.41）、转移性疾病（OR：2.37；95% CI：2.23–2.53）、近端肿瘤（OR：1.59；95% CI：1.50–1.68）以及艾伯塔省的北部地区（与南部地区相比，OR：1.75；95% CI：1.55–1.98）。研究结论：CRC患者在诊断前三个月内至少访问一次急诊科的情况并不少见。与频繁的预诊断急诊科就诊相关的因素包括女性性别、较高的合并症负担、晚期阶段、近端肿瘤以及居住在艾伯塔省的北部地区（该地区专业护理可及性有限）。