Abstract
338 Characterization of melanoma referrals to UIHC and impact on patient outcomes
Journal of investigative dermatology, Vol.144(8 Supplement), pp.S58-S58
08/2024
DOI: 10.1016/j.jid.2024.06.354
Abstract
The aim of this study was to characterize community melanoma referral patterns to the University of Iowa Hospitals and Clinic (UIHC) to identify areas of need and optimize referral guidelines through community partnerships in Iowa, a model for melanoma care across the rural US. This retrospective review analyzed melanoma cases seen at UIHC from 2016-2021 were identified through TriNetX, an analytics network used to query electronic medical records. Descriptive statistics for preliminary data (n=252) were generated using excelv.2312. Only 35% of melanoma cases were diagnosed at UIHC but 85% received treatment at UIHC. stage I disease represented only 64% of cases in Iowa compared with 74% nationally. After procedural intervention, 22% of patients previously categorized at stage II disease were upstaged to either stage III or IV disease. Patients biopsied outside but undergoing excision at UIHC waited on average over 1 month longer between procedures than when the biopsy and excision locations matched. Surgical excisions at UIHC were most often performed by dermatology (44%) and then surgical oncology (34%) while general surgery (33%) led excision performance outside UIHC with dermatology at 16%. Non-UIHC facilities performed more sentinel lymph node biopsies (SLNBs) at Breslow depth < 1mm (23% v. 4%) and overall (51% v. 31%). Transition of melanoma care between Iowa community facilities and a tertiary care site (UIHC) can lead to longer time to treatment between biopsy and excision, upstaging of disease as well as fewer SLNB. Inaccurate Breslow depth on initial biopsy can contribute to delay of proper treatment. The evolving discussion around the utility of SLNB was not reflected in rural care. Thus, timeliness and quality for melanoma care may differ at tertiary v. community rural settings, warranting further intervention.
Details
- Title: Subtitle
- 338 Characterization of melanoma referrals to UIHC and impact on patient outcomes
- Creators
- S.E. Rand - Carver College of Medicine, Iowa City, Iowa, United StatesJ.N. Smart - Carver College of Medicine, Iowa City, Iowa, United StatesA. Chen - Dermatology, University of Iowa Hospitals & Clinics, Iowa City, Iowa, United StatesM. Milhem - University of Iowa, Hematology, Oncology, and Blood & Marrow TransplantationJ.G. Powers - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Journal of investigative dermatology, Vol.144(8 Supplement), pp.S58-S58
- DOI
- 10.1016/j.jid.2024.06.354
- ISSN
- 0022-202X
- eISSN
- 1523-1747
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 08/2024
- Academic Unit
- Dermatology; Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984688451402771
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