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Original Paper

Impact of Emergency Room Neurologists on Patient Management and Outcome

Moulin T.a · Sablot D.a · Vidry E.a · Belahsen F.a · Berger E.a · Lemounaud P.b · Tatu L.a · Vuillier F.a · Cosson A.a · Revenco E.a · Capellier G.b · Rumbach L.a

Author affiliations

aDepartment of Neurology and bEmergency Care Unit, University Hospital, Besançon, France

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Eur Neurol 2003;50:207–214

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 02, 2003
Accepted: July 26, 2003
Published online: November 27, 2003
Issue release date: November 2003

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 1

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE

Abstract

The frequency and impact of in-patient assessment by a neurologist in the emergency room (ER) setting remain largely underestimated. The objective of our study was to analyse the impact of neurologist in-patient management. Methods: Over a period of 12 months, we prospectively recorded the demographics of patients requiring examination in the ER, the ER team’s tentative neurological diagnosis, the neurology team’s final diagnosis and patient outcomes. The time interval between admission, call for a neurologist and the assessment by the neurologist were recorded. Results: Assessments by neurologists were performed in 14.7% (1,679/11,421) of all patients admitted to the ER. The mean time between admission and examination was 32 (± 36) min, irrespective of the day of the week, and dependent on the tentative diagnosis: shorter for stroke and status epilepticus (p < 0.05) and longer for confusion and vertigo (p < 0.05). The initial causes for examination were: stroke (33.1%), epilepsy (20%), loss of consciousness (9%), headaches (9%), confusion (5.4%), peripheral nervous system disorders (4.4%), vertigo (4.2%), cognitive dysfunctions (4%), gait disorders (3.2%) and miscellaneous (7.1%). Overall, false positive or negative diagnoses were produced by the ER in 37.3 and 36.6% of ER admissions, respectively. A complete change of diagnosis by the neurologist was found in 52.5% of patients. Of the patients undergoing a neurological examination, 18.4% were able to go home, 31.8% were admitted to the stroke unit, 32.4% to the general neurology unit and 17.4% to other departments. Conclusion: Our study stresses the need for a neurologist in the ER, both in quantitative terms and for the benefit of patient management.

© 2003 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 02, 2003
Accepted: July 26, 2003
Published online: November 27, 2003
Issue release date: November 2003

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 1

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE


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