Raine et al (2010) showed how hospital data could be used to look at late, unplanned presentation for three common cancers.
Shawihdi et al (2011) found that unplanned presentation was associated with poorer outcomes for oesophagogastric cancers and suggested that it could be a quality indicator for local services.
An unplanned presentation occurred in 129/532 patients, and relative to those with a planned presentation, these patients were more likely to die within 90 days (12.4% vs. 3.1%; p = 0.001), with a longer hospital admission (median, 9 vs. 3 days; p < 0.001) at the time of RRT initiation.
Unplanned re-presentations: any patient who re-presented to the same ED within 24 h or after 48 h of initial presentation, not for planned follow-up or prearranged treatment (such as surgical management).
ED outcomes measured in this study (time to see a clinician, ED LOS, O&G referral/consult, hospital admission, unplanned re-presentations within 24 h and greater than 48 h) are presented in table 3. The overall median time waiting to be seen by a clinician was 31 min (IQR: 15 60 min).
Pre-EPAS EPAP imPre-EPAS EPAPand post-EPAS–EPAP implementation differences were identified using inferentiandstatistics; spost-EPAS EPAPann–Whitney U test for non-post-EPAS EPAPtimplementation differencesime to see a clinician, ED LOS) and χ test for categorical data (eg, unplanned re-presentation to the ED, hospital admission, number/type of pathology and other tests ordered).
Additionally, patients stratified into high (>3) and low (<3) co-morbidities, unplanned or referred presentations and age groups stratified into greater and less than 65 years had marked differences in overall survival.
Outcomes measured included time to see a clinician (primary outcome), ED LOS, admission rate and unplanned ED re-presentation rates (<24 h and >48 h) (secondary outcomes).
Participants were adults aged 65 or older who were admitted to hospital care as an emergency, including all unplanned, unscheduled, or acute presentations.
