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The Neurologist in the Emergency Room: Prospective Study of the Neurological Emergency Group in Lombardia

Journal of Health Science 2019年第4期7卷 254-261页

作者： marialuisa delodovici Marco Mauri Megi Meneri Marco Gallazzi Elena Ballabio Giuseppina Borutti Maria Vittoria Calloni Elisa Candeloro Bruno Censori Claudio De Piazza Laura Fusi Franca Mazzucchelli Ignazio Santilli Elisabetta Forapani Chiara Scaccabarozzi Maria Sessa Lucia Tancredi Massimiliano Braga Dept. of Neurology and Stroke Unit Ospedale di Circolo e Fondazione MacchiUniversità dell’InsubriaASST-Settelaghile Luigi Borri 57 21100 VareseItaly Dept. of Neurology Ospedale di Desio (MB) Director G. Mazzini 1 20832 Desio (MB)Italy Dept. of Neurology ASST Lecco-Ospedale A. Manzonidell’Eremo 9/11 23900 LeccoItaly Dept. of Neurology Ospedale di Cremona ASST Cremona Directorle Concordia 1 26100 CremonaItaly Dept. of Neurology Ospedale Sant’Anna ComoRavona 20 22042 SFermo della BattagliaComoItaly Dept. of Neurology Ospedale di Vimercate (MB) Santi Cosma e Damiano 10 20871 Vimercate (MB)Italy Dept. of Neurology Ospedale S. Carlo BorromeoA. Mosca 12 20152 MilanoItaly Dept. of Neurology Director Ospedale Civile di VogheraVolturno 14 Voghera 27058 (PV)Italy Dept. of Neurology Ospedale di Legnano ASST Ovest MilanesePapa Giovanni Paolo II20025 Legnano (MI)Italy Dept. of Neurology Fondazione IRCCS C. Mondino Mondino 2Pavia 27100Italy Dept. of Neurology ASST Papa Giovanni XXIII Piazza OMS 1 24127 BergamoItaly Dept. of Neurology Ospedale Valduce ComoDante Alighieri 11 22100 ComoItaly Dept. of Neurology Ospedale di Saronno ASST Valle olonaPiazzale Borella 1 Saronno 21047 (VA)Italy Dept. of Neurology Ospedale S. Antonio Abate Gallarate. Pastori 4 21013 Gallarate VareseItaly

Purpose of the work was to quantify the workloads and the neurologist’s commitment in ER, to verify the management of urgencies and appropriateness of neurological counseling requests. Neurologic emergencies are frequent in elderly patients and are associated with high morbidity and mortality. Due to the aging population, neurologic pathologies in emergency room (ER) are widely expected to increase. The role of the neurologist in this context is controversial. Methods: in 14 operative units of neurology a prospective collection of neurological evaluations in ER was carried out using boards of detection of the most frequent neurological clinical pictures seen in the course of a week. Data were collected from 738 cases. Attention was focused on cerebrovascular diseases (CVD), impairment of consciousness, epilepsy, headache, dizziness, head trauma and disorders of the peripheral nervous system (PNS). Achievements: neurological consultations were on average 5% of total accesses to ER. The most common pathology seen was ischemic stroke. After counseling most patients were discharged home. The CVD required the greatest commitment to the specialist. The usefulness of the specialized neurological “filter” has been confirmed in a non-simple operative context, aimed at optimizing the appropriateness of the hospitalization and the economy of the diagnostic path.

关键词： Emergency room neurological diseases neurology workload

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