Chapter 4 78 Referral characteristics Patients or their family initiated the ED-visit in 37.3% (Table 2). Two hundred-and-fiftyeight (51.8%) came outside office hours. Most common main symptoms were dyspnoea (22.1%), pain (17.5%) and fever (11.2%). HM-patients more often presented with fever (23.1% versus 9.0% of the ST-patients, p=0.001); ST-patients more often with nausea or vomiting (9.3% versus 2.6% of the HM-patients). Patients had a median of 2 symptoms. Table 2. Emergency department-referral characteristics of 78 patients with a haematological malignancy and 420 patients with a solid tumour. ED-referral Total n=498 HM-patients n=78 ST-patients n=420 n (%) n (%) n (%) P-value Referrer 0.420 GP or elderly care physician 189 (38.0) 25 (32.1) 164 (39.0) Medical specialist 123 (24.7) 23 (29.5) 100 (23.8) Patient or informal caregiver 186 (37.3) 30 (38.5) 156 (37.1) Referral outside office hours 258 (51.8) 40 (51.3) 218 (51.9) 0.919 Main symptom Dyspnoea 110 (22.1) 22 (28.2) 88 (21.0) 0.166 Pain 87 (17.5) 9 (11.5) 78 (18.6) 0.117 Fever 56 (11.2) 18 (23.1) 38 (9.0) 0.001 Neurologic deteriorationa 41 (8.4) 8 (10.3) 33 (7.9) 0.491 Nausea or vomiting 41 (8.2) 2 (2.6) 39 (9.3) 0.025 Weakness or loss of strength 25 (5.0) 6 (7.7) 19 (4.5) 0.256 Bleeding 23 (4.6) 3 (3.8) 20 (4.8) >0.999 Obstipation or diarrhoea 17 (3.4) 1 (1.3) 16 (3.8) 0.493 Fatigue 12 (2.4) 4 (5.1) 8 (1.9) 0.102 Difficulty swallowing or passage problems 9 (1.8) 0 (0.0) 9 (2.1) 0.367 Seizure 9 (1.8) 1 (1.3) 8 (1.9) >0.999 Oedema 8 (1.6) 0 (0.0) 8 (1.9) 0.617 Ascites 7 (1.4) 0 (0.0) 7 (1.7) 0.603 Other 53 (10.6) 4 (5.1) 49 (11.7) 0.062 Admission for New problemb 254 (51.0) 35 (44.9) 219 (52.1) 0.238 Acute problemc 179 (35.9) 24 (30.8) 155 (36.9) 0.295 Number of symptoms, median (range) 2 (0-8) 2 (0-8) 2 (0-7) 0.055 List of abbreviations: HM: haematological malignancy; ST: solid tumour; ED: emergency department; GP: general practitioner. a Confusion, drowsiness, reduced consciousness. b Not reported in the patient records in the last three months. c Onset within the last 24 hours.
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