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Epidemiological investigation of emergency department visits in patients with cancer: a three-center study
Mohammad Masud Khubiari , Simin Najafgholian, Bahareh Abbasi, Ramin Parvizrad, Reza Aghbozorgi,
Volume 82, Issue 5 (August 2024)
Abstract
Background: Emergency Departments (EDs) visits reflect medical needs and demands or the only care available to patients. Many ED visits are potentially preventable with access to high-quality, community-based health care. Given the higher incidence of emergency conditions in patients with cancer the global increase in cancer will pose a challenge for emergency services. Therefore, this study was conducted with the aim of epidemiological investigation of emergency department visits by cancer patients in several centers.
Methods: In this cross-sectional study, the triage form and hospital file of known patients with various cancers, who visited in Eds of valiasr and Amir al Momenin hospitals in Arak, Hazrat Rasool Akram and Lolagar hospitals in Tehran, and Shahid Sadouqi and Shah vali hospitals in Yazd, From April to September 2017. To measure the urgency of ED visits, the emergency severity index and triage form were used, and the outcome of the emergency visit was extracted from the patient's file and recorded in the data collection checklist. Multivariate logistic regression analysis was used to examine the association of patient, hospital and potentially preventable factors.
Results: In this study, 1107 patients, 550 men (%49.7) and 577 women (%50.3) with cancer were were studied. Age 65 and older had the most emergency visits. The most common reason for patients to visit was: pain in different organs (18.2%), fever (8.7%), weakness and malaise (7.5%). A total of 617 (55.7%) visits were potentially preventable. Age 17 years and younger (OR, 3.172; 95% (CI), 2.409-4.021) and presence of more than 1 comorbidity (OR, 3.610; 95% (CI), 3.611-4.521) were positively associated with potentially preventable visits.
Conclusion: In this study, 50.7% of ED visits among patients with cancer were identified as potentially preventable, and the most common reason for patient visits was general and non-specific symptoms such as pain, weakness, and malaise. These findings highlight the need for palliative care and evidence-based interventions in outpatient settings.

Evaluation of the prognosis of the first seizure without a trigger factor in terms of recurrence
Parviz Karimi, Hossein Seidkhani, Zahra Mohebinejad, Shayan Hasanvand,
Volume 83, Issue 4 (July 2025)
Abstract
Background: Seizures are common neurological disorders in childhood, with a prevalence of 4 to 6 cases per 1,000 children in the community. This study was conducted to evaluate the prognosis of the first non-provoked seizure in terms of recurrence.
Methods: In this descriptive-analytical study, the records of all patients hospitalized with a diagnosis of seizure without a trigger for the first time at Imam Khomeini Hospital in Ilam from April 2016 to March 2019 were reviewed retrospectively. Information was extracted from the patients' records. All records were reviewed in terms of seizure type characteristics.
Results: The results of imaging with seizure recurrence in these patients showed that there was a significant relationship between the result of the first imaging and the report of seizure recurrence (P≥0.001 and Phi-Cramers=0.729). Since EEG of all patients was not recorded, they were excluded from the study. There was also a significant relationship between drug treatment and seizure recurrence at a significance level of 5% (P=0.004 and Phi-Cramers=0.273). This study showed that among the 64 patients who had started drug treatment, 44 reported no seizure recurrence and 20 reported seizure recurrence, and among the 54 patients who had not received drug treatment, 23 reported no seizure recurrence and 31 reported seizure recurrence. In the first year, the highest frequency of seizure recurrence was in the first 6 months. With increasing time after seizure, the rate of seizure recurrence decreased. The highest percentage of seizures without a triggering factor was in the age group of 5-10 years and the lowest percentage was in the age group under 5 years.
Conclusion: Identifying key factors associated with seizure recurrence will enable healthcare professionals to tailor their diagnostic and therapeutic approaches, ultimately enhancing patient care and safety. By understanding the importance of family history, seizure characteristics, and neuroimaging findings, clinicians can make informed decisions that may prevent life-threatening complications and minimize cognitive impairment in affected children.

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