Analysis of urgent inpatient neurologic consultations in a large tertiary hospital center: Follow‐up on the effect of standardized training of residents

Abstract

Background Clinical neurology is difficult for young residents. To familiarize with neurological emergencies as soon as possible for young doctors, the urgent inpatient neurologic consultations were analyzed. Methods A retrospective study was conducted on the urgent inpatient neurologic consultations in a large tertiary hospital for 4 consecutive years. Results A total of 1437 cases were included, and the annual consultation cases gradually decreased from 573 to 257, involving 29 clinical departments. The disorders of urgent inpatient neurologic consultations were divided into three categories: neurological disorders (77.8%), non‐neurological disorders (10.4%), and undiagnosed disorders (11.8%), common causes in consultation were disturbance of consciousness (36.0%), convulsions/stiffness (13.6%), limb weakness (8%), and mental disorder (5.6%). Common neurological disorders included acute cerebrovascular disease (33.6%), epilepsy/status epilepticus (15.8%), and metabolic or infectious toxic encephalopathy (14.9%). Conclusion Urgent inpatient neurologic consultations involve multidisciplinary critical diseases, mainly neurological diseases. The standardized training of residents may help to rapidly improve the comprehensive diagnosis and treatment ability of young residents and is suitable for use in hospitals at all levels.

Evaluation of inpatients neurology consultations in the department of gynecology, obstetrics, and reproductive medicine of a tertiary hospital in Turkey

“…6,22 In the last study, in which a decrease was observed, the reason for the decrease was attributed to more basic medical information was included in the resident education system. 1 In the present study, together with all of these reasons, we believe that increased defensive medicine is another reason. While the most common reason for consultation was eclampsia, a related disorder to neurology in 2015, we attribute to the same reasons why pre-eclampsia, which is less related to neurology than eclampsia, was the most common reason for consultation in 2022.…”

“…In contrast, urgent inpatient neurological consultations decreased year by year in another study. 1 In the first two studies, an increase in consultations was supposed to be associated with growing diagnostic complexity and specific treatment approaches in neurology. 6,22 In the last study, in which a decrease was observed, the reason for the decrease was attributed to more basic medical information was included in the resident education system.…”

“…Pregnancy, menopause, and hormonal therapy are associated with neurological diseases. 1 The contribution of inpatient neurology consultations to patients' management is important. After neurology evaluation, 21-63% of patients had a change in diagnosis, and 21-88% of patients in their treatment plan.…”