Evaluating the functioning of a rapid diagnostic unit of patients with Constitutional syndrome: a retrospective study

Abstract

BACKGROUND: Constitutional syndrome (CS) is a group of non-specific symptoms (asthenia, anorexia and involuntary weight loss) frequently found in the setting of a wide range of diseases, amongst which cancer is the most important. Those in charge of carrying out the diagnostic approach of patients with CS are the Rapid diagnostic units. This unit’s main objectives are to reduce diagnostic delays at the same time of preventing unnecessary admission, since they are ambulatory care units. PURPOSE: To evaluate the functioning of the Rapid diagnostic unit of Hospital Universitari de Vic in terms of agility and rapidity of the CS evaluation and detect alterations in order to improve them. And to know the frequency of the diseases responsible for the constitutional syndrome. METHODS: We analysed the medical history of all the patients with constitutional syndrome attended at the Rapid Diagnostic Unit in two years (from May 2015 to April 2017). RESULTS: a total of 88 patients were referred to the unit from different health facilities (specially from primary health care and emergency department). The unit took a median of 3 days to visit patients with CS since they were referred and a median of 3 more days to achieve the diagnosis. The median time to get complementary tests performed and the medical report obtained was 5,5 days. The most frequent cause of CS was cancer (37,5% of all the diagnosis), followed by psychiatric diseases (22,7% of all the diagnosis). The most frequent type of cancer were the digestive neoplasms, and amongst all the cancer, 60,6% presented metastasis at the moment of the diagnosis. CONCLUSION: The rapid diagnostic unit of Hospital Universitari de Vic is efficient in speeding up the diagnostic process of patients with CS. In the case of potentially serious diseases, as cancer, the unit has the agility to accelerate the diagnostic procedures as much as possible, so the best therapeutic approach can be conducted in these patients. The most common diseases responsible for constitutional syndrome were malignant neoplasms, which most of them had already advanced stages. Cancer was followed, in decreasing frequency, by psychiatric disorders and organic but non-neoplastic diseases as digestive diseases