テラハラ　アツロウ   Terahara Atsuro   寺原　敦朗    所属   東邦大学  医学部 医学科（大森病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Factors that Delay Treatment of Symptomatic Metastatic Extradural Spinal Cord Compression
掲載誌名	正式名：JOURNAL OF PALLIATIVE MEDICINE 略　 称：J Palliat Med ISSNコード：15577740
巻・号・頁	10.1089/jpm.2014.0099,pp.25343305
著者・共著者	Tsukada Y†, Nakamura N, Ohde S, Akahane K, Sekiguchi K, Terahara A†
担当区分	最終著者
発行年月	2014/10
概要	Abstract Background: Treatment delays of metastatic extradural spinal cord compression (MESCC) sometimes have been reported, but reasons for its delay have remained unclear. The purpose of this study was to assess which clinical factors are associated with treatment delays in neurologically symptomatic MESCC in the hospital settings. Methods: We reviewed medical records of MESCC patients in our institute who had at least one progressive neurological symptom (weakness, sensory changes, urinary retention, or nerve root pain), were diagnosed by magnetic resonance imaging (MRI), and were treated with at least radiotherapy. The number of days prior to treatment initiation were counted and defined as follows: from the patients' first physician visit to our hospital until MRI diagnosis [T1 (days)], from MRI diagnosis to treatment [T2 (days)], and from patients' first visit to treatment [T1+2 (days)]. Nine clinical factors that could potentially delay treatment were analyzed for each period. Results: Forty-three episodes of MESCC met the inclusion criteria. Median days in T1+2 was 3 days (range: 0-22). T1 and T1+2 were significantly higher in patients with normal walking status than in those with deterioration or inabilities to walk (T1+2, 7 days versus 3 days, median, p<0.001). The number of days was higher in all periods when it included weekends (T1+2, 7 days versus 2 days, median, p<0.001). Conclusions: Our findings suggest that normal walking status at the first physician visit and inclusion of weekends during the pretreatment periods were factors that resulted in treatment delays even for MESCC patients with emergency neurological symptoms.
DOI	10.1089/jpm.2014.0099
文献番号	25343305