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The Profile of Neurology Patients Evaluated in the Emergency Department

机译：急诊科评估神经病患者的概况

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OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood count, serum glucose level, urea, creatine, erythrocyte sedimentation rate, and D-dimer levels) and imaging findings were retrospectively evaluated based on patient charts. RESULTS: Impaired consciousness was the most frequent reason for neurological consultation (19.7%). Among these patients, ischemic stroke was diagnosed in 27.9%, hypoxic encephalopathy in 18.2%, cerebral hemorrhage in 9.1%, and 11% had no neurological diagnosis. Other common reasons for neurological consultation were vertigo, headache, seizure, and stroke. Clinical findings were related to other systemic causes in 43.7% of the study group. Focal neurological findings were present, especially in patients that presented with ischemic and hemorrhagic stroke, epilepsy, and hypoxic encephalopathy. CONCLUSION: In emergency departments, metabolic causes should be ruled out in patients with impaired consciousness and the absence of focal neurological signs. Intracranial structural disorders must be evaluated when focal neurological signs are present. Cautiously prepared algorithms and neurological examination training will help improve the accuracy of emergency department diagnoses.
机译：目的：早期，快速和多学科的方法对急诊科的神经系统疾病的诊断非常重要。本研究旨在调查急诊科接受神经科咨询的患者的特征。方法：本研究包括780例患者。回顾性地评估了患者的人口统计学特征，急诊治疗和神经科咨询的原因，神经科医生的神经系统诊断以及实验室（总血细胞计数，血清葡萄糖水平，尿素，肌酸，红细胞沉降率和D-二聚体水平）和影像学发现在病人图表上。结果：意识障碍是神经科会诊的最常见原因（19.7％）。在这些患者中，缺血性中风占27.9％，缺氧性脑病占18.2％，脑出血占9.1％，而11％没有神经系统诊断。神经科会诊的其他常见原因是眩晕，头痛，癫痫发作和中风。研究组中43.7％的临床发现与其他全身原因相关。存在局灶性神经系统发现，特别是在患有缺血性和出血性中风，癫痫和缺氧性脑病的患者中。结论：在急诊科，应排除意识障碍和缺乏局灶性神经系统体征的患者的代谢原因。存在局灶性神经系统体征时必须评估颅内结构障碍。精心准备的算法和神经系统检查培训将有助于提高急诊科诊断的准确性。

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