O recurso da tomografia de crânio em pacientes oncológicos que buscam o pronto-atendimento hospitalar

Abstract

During the treatment or post-treatment period, the cancer patient may present changes in his general health, such as neurological changes, related to several factors linked to the progression of the disease, metabolic disorders and treatment. Imaging exams play a fundamental role in the evaluation of cancer patients and their complications in the emergency department. Computed tomography is one of the main diagnostic imaging methods used. Knowing that technological resources are available in a non-homogeneous way in our environment, and that the increasing demand for cancer services in the country, knowledge of the epidemiological and clinical profile, indications and findings of these exams can help in the optimization of the use of the tomography resource computerized in this population. Objective: To verify the profile of use of the computed tomography resource in cancer patients who seek the emergency department of a reference cancer Center, correlating the indications and the clinical profile of the patients with the computed tomography findings. Material and method: The present study carried out a retrospective analysis of the medical records of patients who entered the emergency department with the presence of neurological symptoms and underwent cranial computed tomography in 2016 (n = 224). Results: Patients with mild neurological symptoms 51 (46.4%) had an examination with radiological findings and 71 (58.2%) patients with serious neurological symptoms had an examination with positive radiological findings (p <0.005) and 50 (69.5 %) of the 72 patients who had return to the emergency department had an examination with positive radiological findings (p <0.005). Conclusion: From the analysed parameters, we can highlight the age, return, presence of metastasis and severe neurological symptoms as predictive factors for examination with radiological alteration. It can assist in the optimization of the use of computed tomography of the skull and neurological emergencies in cancer patients.