Characteristics, diagnosis and outcome of patients referred to a specialized neurology emergency clinic: prospective observational study

Çoban, Eda; Mutluay, Belgin; Şen, Aysu; Keskek, Asli; Atakl, Dilek; Soysal, Aysun

doi:10.5144/0256-4947.2016.51

Cited by 15 publications

(21 citation statements)

References 14 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Neurological conditions account for 10 to 15% [1] of patients visiting the emergency department (ED), of which 13 to 27.8% are represented by patients with non-traumatic headache as the main complaint [2][3]. These numbers, according to several descriptions represent 0.5 to 2.8% of the emergency visits[4].…”

Section: Introductionmentioning

confidence: 99%

Headache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flags

et al. 2019

View full text Add to dashboard Cite

IntroductionNon-traumatic headaches account for 0.5 to 4.5% at the emergency department (ED). Although primary headaches represent the most common causes, the likelihood of ominous etiology has to be considered by clinicians in order to avoid diagnostic and therapeutic pitfalls. Due to the absence of biological or imaging findings to diagnose primary headaches we hypothesize ICHD 3(International Headache criteria 3) criteria as a useful tool at the moment to identify and to establish a difference between those patients who are undergoing primary headaches and those who will need advanced diagnostic strategies.ObjectivesTo determine the usefulness of ICHD 3 criteria to differentiate primary from non-primary headaches at the emergency department (ED).MethodsDuring five weeks all the patients complaining of headache attended at the triage unit at the ED were interviewed, examined and classified as having primary or non-primary headaches by means of ICHD 3 criteria. Those patients with primary headaches were treated according to standard of care protocols and followed up by means of phone call communication after 48 hours to assure satisfactory outcome. Those patients classified as having non-primary headaches (secondary headaches and neuralgias) were admitted for additional diagnostic and therapeutic interventions. Between both groups we compared the prevalence of fulfilled criteria for primary headaches and the proportion of traditional red flags such as age, sleep headache onset, associated symptoms, abnormal neurological exam, sudden onset, and nonresponse to analgesics in addition to previous consultation before this evaluation.ResultsHeadache was responsible for 244 (2.3%) out of 10450 admissions at the ED, 77.8% were females. Primary, non-primary (secondary plus neuralgias) and unclassified headaches were 59.4%, 32% and 8.6% respectively. Migraine and cervical myofascial pain were the most frequent etiologies for primary and non-primary causes respectively. Factors associated to non-primary etiologies were immunosuppression (OR: 2.7 IC 95% 2.3–3.3) and age older than 50 (OR: 2.7 IC 95% 2.01–3.62). Abnormal neurological exam, sudden and sleep headache onset were not statistically significant.Factors found to be associated with primary headaches were: fulfilling ICHD 3 criteria (OR: 18.7, IC95% 7.1–48.6), history of migraine (OR: 2.9 IC 95% 2.1–3.9), and history of similar episodes (OR: 2.7 IC 95% 2.3–3.3).ConclusionThis data suggests that fulfilling ICHD 3 criteria could be useful to differentiate primary from non-primary headaches. This observation is also valid for immunosuppression, age older than 50, history of migraine and history of similar episodes.

show abstract

Section: Introductionmentioning

confidence: 99%

Headache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flags

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Departments that frequently applied for urgent neurological consultation included the intensive care unit (ICU), respiratory medicine, cardiovascular medicine, hematology, and nephrology. At present, it is estimated that about 10% of patients present some neurological manifestations in the previous reports [10][11][12][13]. It has been reported that neurological consultation in the ICU is often urgent consultation, which also suggests that patients have more severe diseases to be managed.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Urgent Neurologic In-Hospital Consultations in a Large Tertiary Hospital Center in China

Wang¹,

Ren²,

Zeng

2020

Preprint

View full text Add to dashboard Cite

Objective: To determine the current state of urgent neurologic in-hospital consultations, this study investigated urgent neurologic in-hospital consultations in a large tertiary hospital in China over a 4-year period. Methods: We conducted a retrospective study of urgent neurologic in-hospital consultations in a large tertiary hospital for 4 consecutive years (Jan. 1, 2014 to Dec. 31, 2017). The clinical data of patients who received urgent neurologic in-hospital consultations were obtained from the electronic medical record system and analyzed. Results: A total of 1437 cases (age range: 9-103 years old; average age: 60.3; males: 54.6%) were included in the study; 57.5% of the consultations were in line with urgent consultation criteria. The departments applying for urgent consultation involved 29Twenty-nine clinical departments were involved in the urgent consultations. consciousness disorder (36.0%), tics/stiffness (13.6%), limb weakness (8%), and mental disorders (5.6%). Urgent consultation diseases were divided into three categories: neurological diseases (77.8%), non-neurological non-neurological diseases (10.4%), and undiagnosed diseases (11.8%). The common neurological disorders included urgent cerebrovascular disease (33.6%), epilepsy/status epilepticus (15.8%), and metabolic or infective toxic encephalopathy (14.9%). Conclusions: Most urgent neurologic consultation is in line with consultations followed the guidelines for urgent neurologic consultation criteria. Non-neurologic. Non-neurological physicians in clinics should enrich their knowledge of frequently occurring urgent and critical neurological diseases.

show abstract

“…Early intervention by a neurologist is needed to diagnose patients with neurologic symptoms at an early stage and provide accurate initial treatment in the ED. Studies have demonstrated that a dedicated neurologist in the ED reduced the length of stay and the hospital admission rate [ 3 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Experience of a Neuro-Emergency Expert in the Emergency Department during One Year of the COVID-19 Pandemic

Jung

Kim

et al. 2021

IJERPH

View full text Add to dashboard Cite

We aimed to evaluate the overall clinical characteristics of patients treated by a neuro-emergency expert dedicated to the emergency department (ED) as an attending neurologist during the COVID-19 pandemic. We included adult patients who visited the ED between 1 January and 31 December 2020 and were treated by a neuro-emergency expert. We retrospectively obtained and analyzed the data on patients’ clinical characteristics and outcome. The neuro-emergency expert treated 1155 patients (mean age, 62.9 years). The proportion of aged 18–40 years was the lowest, and the most common modes of arrival were public ambulance (50.6%) and walk-in (42.3%). CT and MRI examinations were performed in 94.4 and 33.1% of cases, respectively. The most frequent complaints were dizziness (31.8%), motor weakness (24.2%), and altered mental status (15.8%). The ED diagnoses were acute ischemic stroke (19.8%), benign paroxysmal positional vertigo (14.2%), vestibular neuritis (9.9%), and seizure (8.8%). The mean length of stay in the ED was 207 min. Of the patients, 55.0% were admitted to the hospital, and 41.8% were discharged for outpatient follow-up. Despite the longer stay and the complexity and difficulty of neurological diseases during the COVID-19 pandemic, the accurate diagnosis and treatment provided by a neuro-emergency expert can be presented as a good model in the ED.

show abstract

Characteristics, diagnosis and outcome of patients referred to a specialized neurology emergency clinic: prospective observational study

Cited by 15 publications

References 14 publications

Headache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flags

Headache at the emergency room: Etiologies, diagnostic usefulness of the ICHD 3 criteria, red and green flags

Analysis of Urgent Neurologic In-Hospital Consultations in a Large Tertiary Hospital Center in China

Experience of a Neuro-Emergency Expert in the Emergency Department during One Year of the COVID-19 Pandemic

Contact Info

Product

Resources

About