Inpatient use and usefulness of a district general hospital neurologist

Fitzpatrick, Ashli; McCarron, Mark O.

doi:10.1136/pgmj.2007.063172

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…Further evidence of patient benefit from a liaison neurology service has also come from Forbes et al ,10 who demonstrated that a daily service shortened length of stay compared with medical management without such a liaison service in a teaching hospital. Despite increasing numbers of neurologists based in DGHs, very few studies have tried to demonstrate benefit from neurologists providing a liaison service in a DGH 8 15. One report of a teleneurology service for neurological inpatients in a small DGH has shown that such a service can reduce length of hospital stay 15.…”

Section: Discussionmentioning

confidence: 99%

“…The contribution of neurologists to diagnosis, management, reduction in length of stay, and improving clinical outcomes has been documented in tertiary referral and teaching hospitals, but data from general hospitals are lacking. Diagnostic errors by non-neurologists are common, particularly in conditions such as epilepsy7 and non-organic illness 8. However, a number of retrospective studies have shown that diagnostic change following the input of a neurologist occurs in 33–52% of inpatient referrals 8–12…”

Section: Introductionmentioning

confidence: 99%

“…A liaison neurology service may enhance acute neurology inpatient care in DGHs, but clinical data are limited 8 15. In this study we therefore examined the impact of a DGH liaison neurology service for diagnosis and management of patients with neurological symptoms and assessed the diagnostic reliability of the service.…”

Section: Introductionmentioning

confidence: 99%

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The value of a liaison neurology service in a district general hospital

McColgan

Carr

McCarron

2010

Postgraduate Medical Journal

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The value of a liaison neurology service in a district general hospital

McColgan

Carr

McCarron

2010

Postgraduate Medical Journal

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“…Despite these statistical logics whenever available, expert neurologic assessment and management can alter the working diagnosis and can have a positive impact on overall hospital management [7]. Diagnostic errors by non neurologists are not very uncommon, especially regarding epilepsy and other non-organic illness [8,9]. Retrospective studies have also shown that diagnostic change following neurology consultation is seen in 32-50% of inpatient referrals [10-12].…”

Section: Introductionmentioning

confidence: 99%

“…Retrospective studies have also shown that diagnostic change following neurology consultation is seen in 32-50% of inpatient referrals [10-12]. Studies have also proved that a liaison with neurology consultation may improve inpatient care in UK [9,13]. …”

Section: Introductionmentioning

confidence: 99%

Pattern of neurological disease seen among patients admitted in tertiary care hospital

et al. 2014

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BackgroundNeurologic disorders are not uncommon at in patient departments of different hospitals. We have conducted the study to see the pattern and burden of neurologic disorders at different inpatient departments of a tertiary care centre.MethodologyThis retrospective observational study was carried out from the records and referral notes of neurology department of Dhaka Medical College Hospital (DMCH) from July 2011 to June 2012. A total 335 patients were evaluated by consultant neurologists during this period.ResultMajority of the patients (59.7%) presented after the age of forty years. The mean age at presentation was 45.11 ± 17.3 years with a male predominance (63.3%). Stroke was the most common condition (47.5%) observed at referral, followed by seizure (9.3%), disease of spinal cord (7.8%) and encephalopathy (6.3%). Even after consultation, 30 patients remained undiagnosed and 6 were diagnosed as functional disorder. Department of Medicine (231, 69%) and Cardiology (61, 18.2%) made most of the calls. More than half (56%) of the stroke patients were referred from medicine and one third (35.2%) from cardiology. Seizure (67.7%), problem in spinal cord (92.3%), coma (50%), encephalopathy (57.1%), motor neuron disease (MND) (72.7%) were common reasons for referral from department of Medicine. Whereas patients with cord disease (7.3%), CNS tumor (40%), seizure disorder (6.5%) and stroke (3.8%) were referred from surgery. Department of Obstetrics and Gynecology sought help for stroke (2.5%), seizure (12.9%), MND (27.3%), coma (16.7%) and encephalopathy (9.5%).Hypertension, diabetes, ischemic heart disease, dyslipidaemia and respiratory problem were significantly associated co-morbid conditions in stroke patients (at 95% CI, p value is <0.001, <0.01, <0.001, <0.05, <0.05 respectively). Hematological disorders were common association among patients with cord problem (<0.05).ConclusionWide ranges of neurological problems are often managed by physicians and surgeons, especially those from medicine and cardiology. Where ever available consultation from neurologists can help in diagnosing and managing these cases.

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