[Repercussion of age on management of neoplastic patients in an Internal Medicine Service]. / Relación de la edad con el manejo de los pacientes diagnosticados de neoplasia en un Servicio de Medicina Interna.

AIM: To determine whether age is a factor affecting the management of patients diagnosed with neoplastic disease in an internal medicine service. PATIENTS AND METHODS: Prospective study of 388 patients diagnosed with cancer in the internal medicine service of a large public health teaching hospital. We evaluated clinical characteristics, diagnostic procedures, types and stage of neoplasm, referral after hospital discharge and treatment. A comparative study based on age was performed between patients 65 years older and patients under this age. RESULTS: The 388 cancer patients accounted for 12% of hospital admissions in our service. Among the total, 62% were > or = 65 years old. Constitutional syndrome, the most frequently associated symptom and the main reason for the consultation, was more common in the > or = 65-year-old group. Lung cancer was predominant in men and hematologic neoplasms in women. Patients > or = 65 were referred more frequently to internal medicine physicians, general practitioners and home palliative assistance services (p < 0.05) and they received only palliative treatment in a greater percentage of cases (50% vs. 37%, p = 0.001). CONCLUSIONS: The incidence of neoplasms in our service was high (12%), with a considerable percentage of patients in advanced phases of the disease (83%). Age was not related to diagnostic methods nor was it determinant in the staging, but it did have repercussions on treatment; patients > or = 65 received palliative treatment alone more often than younger patients.

Relación de la edad con el manejo de los pacientes diagnosticados de neoplasia en un Servicio de Medicina Interna / Repercussion of age on management of neoplastic patients in an Internal Medicine Service

Objetivo: Valorar la relación de la edad con el manejo de los pacientes diagnosticados de neoplasia en un servicio de Medicina Interna. Pacientes y métodos: Estudio prospectivo de 388 pacientes diagnosticados de cáncer en un Servicio de Medicina Interna. Se evalúan las características clínicas, procedimientos diagnósticos, tipos de neoplasia y estadiaje, derivación al alta y tratamiento. Se realiza un estudio comparativo basado en la edad, pacientes de 65 años o mayores frente a los más jóvenes. Resultados: Los 388 pacientes diagnosticados de cáncer supusieron un 12% de los ingresos en nuestro servicio. El 62% tenían 65 años. El síndrome constitucional fue la sintomatología más frecuente asociada y el principal motivo de consulta, siendo más relevante en los 65 años. El cáncer de pulmón fue el más frecuente en los hombres y las neoplasias hematológicas en las mujeres. Los enfermos 65 años fueron controlados con más frecuencia por Medicina Interna, médico de cabecera y Servicio de Asistencia Paliativa a Domicilio (P<0,05) y recibieron tratamiento únicamente paliativo en un mayor porcentaje de casos (50% vs 37%, p=0,001). Conclusiones: La incidencia de neoplasias en nuestro servicio fue alta (12%), con un alto porcentaje de pacientes en fases avanzadas de la enfermedad (83%). La edad no se relacionó con el manejo diagnóstico ni demostró ser determinante en el estadiaje, pero sí en el tratamiento, puesto que los pacientes 65 años recibieron con mayor frecuencia tratamiento paliativo (AU)

Aim: To determine whether age is a factor affecting the management of patiens diagnosed with neoplastic disease in an internal medicine service. Patients and methods: Prospective study of 388 patients diagnosed with cancer in the internal medicine service of a large public health teaching hospital. We evaluated clinical characteristics, diagnostic procedures, types and stage of neoplasm, referral after hospital discharge and treatment. A comparative study based on age was performed between patients 65 years older and patients under this age. Results: The 388 cancer patiens accounted for 12% of hospital admissions in our service. Among the total, 62% were >= 65 years old. Constitutional syndrome, the most frequently associated symptom and the main reason for the consultation, was more common in the >= 65-year-old group. Lung cancer was predominant in men and hematologic neoplasms in women. Patients >= 65 were referred more frequently to internal medicine physicians, general practitioners and home palliative assistance services (p<0.05) and they received only palliative treatment in a greater percentage of cases (50% vs. 37%, p=0.001). Conclusions: The incidence of neoplasms in our service was high (12%), with a considerable percentage of patients in advanced phases of the disease (83%). Age was not related to diagnostic methods nor was it determinant in the staging, but it did have repercussions on treatment; patients >=65 received palliative treatment alone more often than younger patients (AU)