Onkoloji dal hastanesi acil servisine başvuran kanser hastalarında ağrı ve ilişkili klinik faktörlerin değerlendirilmesi

Öz

Amaç: Acil servise (AS) ağrı şikayeti ile başvuran kanser hastalarında vizüel analog skala (VAS) skoru, ağrının lokalizasyonu, klinik son durum ve tanı, kanser tipi, evre ve metastaz gibi faktörler arasındaki ilişkiyi değerlendirmek amaçlandı. Gereç ve Yöntemler: 2023-2024 yıllarında AS’ye ağrı şikayeti ile başvuran kanser hastalarının yaş, cinsiyet, komorbid hastalıklar, kemoterapi (KT), radyoterapi (RT) ve cerrahi öyküsü, primer organ, kanser tipi, süresi, evresi, metastaz, VAS skoru, tanı kodları ve yatış/taburculuk durumu hastane veritabanından ve hasta dosyalarından kaydedildi. VAS skorları ile klinik özellikler ve klinik son durum arasındaki ilişki incelendi. Bulgular: Hastaların medyan yaşı 59.0 (16.0)’dı. Medyan kanser tanı süresi 5.0 (2.0) yıldı. Hastaların yaklaşık ¾’ü ve ¼’ü son bir ay içinde sırasıyla KT ve RT almıştı. Hastaların %12,2’sinde başka tanı yoktur ve analjezik tedavi almıştı. Hastaların %44,2’sinde tanısal ICD kodu yoktur. VAS skoru ortalaması 7.0 (3.0)’dı. Sadece ağrı ile AS’ye başvuran hastaların VAS skoru 8.0 (2.0) idi. VAS skorları metastatik hastalığı olan, son bir ay içinde RT alan ve kemik metastazı olan hastalarda daha yüksekti. Sadece ağrı olan hastalarda yapılan korelasyon analizi, hastaneye yatma riski ile performans skoru arasında zayıf bir pozitif korelasyon olduğunu göstermiştir (Rho = 0.232, p = 0.004). Sonuçlar: VAS skorları, metastatik hastalığı olan, son bir ay içinde RT alan ve kemik metastazı olan hastalarda daha yüksekti ve sadece ağrı ile AS’ye başvuran hastalarda hastaneye yatma riski ve performans skoru ile zayıf pozitif korelasyon göstermiştir. Kanser ağrısının şiddeti, hastanın genel durumunun kötüleşmesiyle birlikte hastaneye yatış oranının artmasına neden olabilir.

Anahtar Kelimeler

• neoplazm
• acil servis
• ağrı ölçümü

Evaluation of pain and associated clinical factors in cancer patients presenting to the emergency service of an oncology branch hospital

Öz

Aim: This study aimed to evaluate the relationship between the visual analog scale (VAS) score, pain localization, clinical outcome, and factors such as diagnosis, cancer type, stage, and metastasis in patients presenting to the emergency service (ES) with pain. Materials and Methods: Age, gender, comorbid diseases, history of chemotherapy (CT), radiotherapy (RT), and surgery, primary organ, cancer type, duration, stage, metastasis, VAS score, diagnostic codes, and hospitalization/discharge status were recorded from the hospital database and patient files in cancer patients who presented to the ES with pain in 2023- 2024 years. The relationship between VAS scores and clinical characteristics and outcomes was examined. Results: The median age was 59.0 (16.0) years. The median cancer diagnosis was 5.0 (2.0) years. Nearly three-quarters of patients had received CT in the last month, and a quarter had received RT. 12.2% of patients had no other diagnosis and received analgesic therapy. 44.2% of patients had no diagnostic ICD code. The median VAS score was 7.0 (3.0). The VAS score of the patients admitted to ES with only pain was 8.0 (2.0). VAS scores were higher in patients with metastatic disease, who received RT in the last month, and those with bone metastasis. Correlation analysis in patients with only pain symptoms revealed a weak positive correlation between the risk of hospitalization and performance score (Rho = 0.232, p = 0.004). Conclusion: VAS scores were higher in patients with metastatic disease who received RT in the last month and those with bone metastasis, and showed a weak positive correlation with the risk of hospitalization and performance scores in patients presenting to ES with only pain symptoms. The severity of cancer pain may result in an increased hospitalization ratio along with deterioration of the patient’s general condition.

Anahtar Kelimeler

• neoplasm
• emergency service
• pain measurement

Kaynakça

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