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We found the numbers of ED presentations were higher for people from lower socioeconomic areas and those who died at a younger age.
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These findings are consistent with those reported by Townsend et al 12 and Hendrix et al. 9 Alcohol involvement in IDO presentations was higher than that reported by other studies 9 and higher in Northern Ireland than in Ireland.
Although the BSRBR-RA did not collect information on tumour stage at the time of diagnosis, the Swedish study found tumour stage at presentation to be largely similar between the groups, although the proportion of late presentations was higher in the control cohort (29% vs 20% stage IV), suggesting there may be a degree of surveillance bias in TNFi patients.
At least in settings such as ours in which patients are referred to the Emergency Room after a few days of empirical treatment, the prevalence of incomplete oligosymptomatic presentations is high.
Perceived barriers to symptomatic presentation were highest in the UK, in particular being worried about wasting the doctor's time (UK 34% Canada 21% Australia 14% Denmark 12% Norway 11% Sweden 9%).
Platelet count at presentation was higher in patients with chronic ITP.
Taken altogether, this means that impairment due to medication side effects was unlikely to be a significant confounder in this study population, although it is conceivable that lack of or low doses of medication may mean that the level of acute distress at presentation was higher than in more comprehensively medicated samples.
When these three risk factors are combined, the rate of emergency department presentation is higher than for each risk factor on its own.
As an example, among patients with oral or oropharyngeal cancer the risk of emergency presentation is higher for men, further increasing notably with increasing deprivation.
Meanwhile, Peters et al. found that liver damage severity at clinical presentation is higher among non-Caucasians than Caucasians for PBC [ 43].
The IOP at CRVO presentation was higher in the pre-existing glaucoma group (mean: 21.7 mmHg) compared to the non-pre-existing glaucoma group (13.9 mmHg).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com