• Carlos Lam, Ching-Feng Kuan, James Miser, Kun-Yi Hsieh, Yu-Ann Fang, Yu-Chuan Li, Chin-Wang Hsu, Ray-Jade Chen, and Chang-I Chen.
• Emergency Department, Wan Fang Hospital, Taipei Medical University, No. 111, Section 3, Hsing-Long Road, Taipei City 116, Taiwan. Electronic address: lsk@wanfang.gov.tw.
• Comput Methods Programs Biomed. 2014 Jul 1; 115 (3): 103-9.

Background And ObjectivePatients who visit emergency department (ED) may have symptoms of occult cancers.MethodsWe studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cancers. The case group was digestive tract cancer patients and the control group was traumatic fracture patients. We reviewed record of ED visits only from 4 to 15 months before the cancer diagnoses.ResultsThere were 2635 and 6665 in the case and control groups respectively. Patients' adjusted odds ratio with 95% confidence interval for the case group were 1.36 (1.06-1.74) for Abdominal ultrasound, 2.16 (1.61-2.90) pan-endoscopy, 1.72 (1.33-2.22) guaiac fecal-occult blood test, 1.42 (1.28-1.58) plain abdominal X-rays, 1.20 (1.09-1.32) SGOT, 1.27 (1.14-1.40) SGPT, 1.66 (1.41-1.95) total bilirubin, 2.41 (1.89-3.08) direct bilirubin, 1.21 (1.01-1.46) hemoglobin and 3.63 (2.66-4.94) blood transfusion, respectively. Blood transfusion in the ED was a significant predictor of the individual subsequently diagnosed with digestive tract cancer.ConclusionsThe health system could identify high risk patients early by real-time review of their ED utilization before the diagnosis of digestive tract cancers. We proposed a follow-up methodology for daily screening of patients with high risk of digestive tract cancer by informatics system in the ED.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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