Pattern of Neurological Disorders among Patients Evaluated in the Emergency Department; Cross–Sectional Study
Archives of Academic Emergency Medicine,
Vol. 11 No. 1 (2023),
15 November 2022
Introduction: Neurologic disorders are common reasons for emergency consultations. Most neurologic disorders seen in the emergency department (ED) are life-threatening and require urgent treatment. The goal of this study is to investigate the pattern of neurological disorders among patients evaluated in the ED.
Methods: This is a cross-sectional study conducted in the ED of Mogadishu Somali Turkish Training and Research Hospital, from July 2021 to February 2022. The clinical and epidemiological characteristics of adult patients with neurologic manifestations in the ED were evaluated. Age, gender, distribution of neurological disease manifestations, neurological examination findings, and neurological diagnoses made by consultant neurologists were assessed.
Results: During the study period, 321 patients were assessed (3.7% of all ED admissions). The majority of the patients in the study were above 50 years of age (62.6% male). Hypertension was the most common comorbidity among these patients with 122 (38%) cases, followed by diabetes mellitus with 65 (20.2%), and heart diseases with 26 (8.1%) cases. The main reasons for neurology consultations were altered mental status with 141 (44%) cases, motor weakness with 102 (31.8%), seizures with 33 (10%), headache with 17 (5.3%), and vertigo with 9 (2.8%) cases. 196 (61%) had hemiplegia, 60 (18.7%) had consciousness impairment, and 38 (11.8%) had normal neurological examination. The most frequent neurological diagnoses were ischemic strokes with 125 (39%) cases, hemorrhagic strokes with 65 (20.2%), epileptic seizures with 28 (8.7%), and metabolic encephalopathies with 13 (4%) cases. The median duration of the neurology consultations was 20 minutes. 251 (78%) of the patients were admitted to the hospital, while 70 (22%) were discharged from the emergency department. After neurology consultation, the neurology department made the most admissions with 226 (90%) cases, while 25 (10%) were admitted by other departments. Of those admitted, 186 (74.2%) were admitted to the neurology ward, and 65 (25.8%) were admitted to the intensive care unit.
Conclusion: In our study, neurologic emergencies accounted for 3.7% of all emergency admissions. Stroke, epileptic seizures, cerebral venous thrombosis, encephalopathies, and acute spinal cord diseases were the most common neurological disorders. The admission rate was very high following neurologic assessment by neurologists.
- Nervous system diseases
- emergency service
How to Cite
Kottapally M, Josephson SA. Common neurologic emergencies for nonneurologists: When minutes count. Cleve Clin J Med. 2016;83(2):116-26.
Olazarán J, Navarro E, Galiano M, Vaquero A, Guillem A, Villaverde F, et al. [Quality of neurological care in the emergency services: a study from the community-hospital]. Neurologia. 2009;24(4):249-54.
McMullan JT, Knight WA, Clark JF, Beyette FR, Pancioli A. Time-critical neurological emergencies: the unfulfilled role for point-of-care testing. International Journal of Emergency Medicine. 2010;3(2):127-31.
Moulin T, Sablot D, Vidry E, Belahsen F, Berger E, Lemounaud P, et al. Impact of Emergency Room Neurologists on Patient Management and Outcome. European Neurology. 2003;50(4):207-14.
Mondal BA, Chowdhury RN, Rahman KM, Khan SU, Hasan A, Hoque MA, et al. Major co-morbidities in stroke patients: a hospital based study in Bangladesh. Journal of Dhaka Medical College. 2012;21(1):16-22.
Solomon G. Pattern of Neurologic Emergencies in Tikur Anbessa Specialized Hospital. Addis Ababa, Ethiopia. 2014.
Warlow C, Humphrey P, Venables G. UK neurologists and the care of adults with acute neurological problems. Clinical Medicine. 2002;2(5):436.
Piecuch JF, Lieblich SE. Neurologic emergencies. Dent Clin North Am. 1995;39(3):567-75.
Moeller JJ, Kurniawan J, Gubitz GJ, Ross JA, Bhan V. Diagnostic Accuracy of Neurological Problems in the Emergency Department. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 2008;35(3):335-41.
Craig J, Chua R, Russell C, Wootton R, Chant D, Patterson V. A cohort study of early neurological consultation by telemedicine on the care of neurological inpatients. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(7):1031.
Emre U, Demir AS, Acıman E, Çabuk N, Kıran S, Ünal A. The Profile of Neurology Patients Evaluated in the Emergency Department. Turkish Journal of Neurology. 2009;15(3):134-9.
Lange M, Braatz V, Tomiyoshi C, Nóvak F, Fernandes A, Zamproni L, et al. Neurological diagnoses in the emergency room: Differences between younger and older patients. Arquivos de neuro-psiquiatria. 2011;69:212-6.
Saddichha S, Saxena MK, Vibha P, Methuku M. Neurological Emergencies in India – Lessons Learnt and Strategies to Improve Outcomes. Neuroepidemiology. 2009;33(3):280-5.
Carroll C, Zajicek J. Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(3):406.
Vural S, Hamamci M, Kilic N. Analysis of the neurology consultations in the emergency department and diagnostic accuracy of emergency physicians for the neurologic emergencies. Annals of Medical Research. 2021;27(6):1797-802.
Geja E, Tadesse F, Deribe B. Neurologic Emergency Outcome and Associated Factors in a Hawassa University Comprehensive Specialized Hospital, Ethiopia. J Neurol Disord. 2019;7(401):2.
Chowdhury RN, Hasan ATMH, Rahman YU, Khan SI, Hussain AR, Ahsan S. Pattern of neurological disease seen among patients admitted in tertiary care hospital. BMC Research Notes. 2014;7(1):202.
Vural S, Ramadan H. A short review on the comparison of consultation systems and tools in the emergency department practice: Tele-consultation. Cumhuriyet Medical Journal. 2019;41(2):239-43.
Owolabi LF, Shehu MY, Shehu MN, Fadare J. Pattern of neurological admissions in the tropics: Experience at Kano, Northwestern Nigeria. Annals of Indian Academy of Neurology. 2010;13(3):167.
Mapoure YN, Ongono JS, Nkouonlack C, Beyiha G, Mouelle AS, Luma HN. Neurological disorders in the emergency centre of the Douala General Hospital, Cameroon: A cross-sectional study. African Journal of Emergency Medicine. 2015;5(4):165-70.
- Abstract Viewed: 392 times
- pdf Downloaded: 663 times