Emergencies in oncology

Thirlwell, Christina; Brock, Cathryn

doi:10.7861/clinmedicine.3-4-306

Cited by 7 publications

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Generally, presentation of MSCC varies from obvious instability with clear clinical deformity and associated pain; to more subtle instability without overt clinical symptoms [23]. Spinal cord compression requires urgent referral and diagnosis by having a high clinical suspicion and with a low threshold to initiate investigation and treatment in order to maintain neurological function [24,25]. The importance of timing of surgery as an important factor contributing to the likely neurological outcome is as outlined in the NICE guidelines [9].…”

Section: Discussionmentioning

confidence: 99%

Clinical pathways of metastatic spinal cord compression: Orthopedics experience based on hospital admissions

Puteh¹,

Khamis²,

Mokhtar³

2015

Integr Mol Med

View full text Add to dashboard Cite

Bone metastases are more common than primary bone cancer. Metastatic bone event of spinal cord compression causes significant morbidity and advances in medical approaches improve management of bone events. Morbidity or healthcare resource utilization could impose an increased pressure on healthcare system. Objective of study is to determine patterns of clinical activities in managing metastatic spinal cord compression secondary to primary breast and prostate cancer patients admitted to orthopedics unit in public teaching hospital. Findings were described into clinical pathways. Within year 2013, majority of patients presented with MSCC had primary breast cancer (60%), Malay ethnicity (70%), presented with neurological deficits (60%), were able to mobilize at presentation (60%), with poorer prognosis (60%), and have pre-existing cancer diagnosis (70%). As many as 583 (19%) numbers of cases screened to have problem related to spine from the ward census. There are two main arms of clinical pathways designed from the data which are surgery and non surgery interventions. Approximately 67% of cases had radiotherapy and remaining 33% received best supportive care within those 60% of 'poor prognosis' arm. Four patients (40%) with 'moderate to good prognosis' arm had surgery followed by radiotherapy. Posterior decompression surgery performed to all patients fits for surgery. Given the increasing incidence of metastatic disease along with evolving treatment options, research related to treatment algorithms can be suggested to further optimize patient outcomes. The essential steps in treating patients with a specific clinical problem of MSCC can be translated into a multidisciplinary care plans known as clinical pathway. The pathways support experts' deciding on allocation of activities and costs incurred in managing MSCC. Findings supports subsequent other economics related study.

show abstract

Section: Discussionmentioning

confidence: 99%