Mary Joanne Verhoef

Chapter 3 58 Table 2. Referral of patients with advanced oncology to the emergency department Referral characteristics n (% of 420) Referrer GP or nursing home physician 150 (35.7) GP out-of-office service 21 (5.0) Medical specialist 100 (23.8) Patient or informal caregiver 143 (34.0) Referral outside office hours 218 (51.9) Referral for a new problema 219 (52.1) an acute problemb 155 (36.9) a new and acute problem 123 (29.3) Number of symptoms, median (range) 2.0 (0-7) Main symptom or sign for referral Dyspnoea 88 (21.0) Pain 78 (18.6) Ascites 50 (11.9) Nausea or vomiting 39 (9.3) Fever 38 (9.0) Neurologic deteriorationc 33 (7.9) Bleeding 20 (4.8) Weakness or loss of strength 19 (4.5) Obstipation or diarrhoea 16 (3.8) Difficulty swallowing or passage problems 9 (2.1) Oedema 8 (1.9) Seizure 8 (1.9) Fatigue 8 (1.9) ECOG performance score 0 4 (1.0) 1 26 (6.2) 2 43 (10.2) 3 89 (21.2) 4 34 (8.1) Unknown 224 (53.3) List of abbreviations: GP = general practitioner; ECOG = Eastern Cooperative Oncology Group a New problem: not reported in the patient records in the last 3 months b Acute problem: originated within the last 24 hours c Neurologic deterioration: confusion, drowsiness, decreased consciousness

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