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Article

Open Access

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

Author(s)

MariaLuisa Delodovici¹, Marco Mauri¹, Megi Meneri¹, Marco Gallazzi¹, Elena Ballabio², Giuseppina Borutti³, Maria Vittoria Calloni⁴, Elisa Candeloro⁵, Bruno Censori⁶, Claudio De Piazza⁷, Laura Fusi⁸, Franca Mazzucchelli⁹, Ignazio Santilli¹⁰, Elisabetta Forapani¹⁰, Chiara Scaccabarozzi¹¹, Maria Sessa¹², Lucia Tancredi¹³ and Massimiliano Braga¹⁴

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DOI:10.17265/2328-7136/2019.04.007

Affiliation(s)

1. Dept. of Neurology and Stroke Unit, Ospedale di Circolo e Fondazione Macchi, Università dell’Insubria, ASST-Settelaghi, le Luigi Borri 57 21100 Varese, Italy
2. Dept. of Neurology, Ospedale S. Carlo Borromeo, A. Mosca 12 20152 Milano, Italy
3. Dept. of Neurology, Director Ospedale Civile di Voghera, Volturno 14 Voghera 27058 (PV), Italy
4. Dept. of Neurology, Ospedale di Legnano ASST Ovest Milanese, Papa Giovanni Paolo II, 20025 Legnano (MI), Italy
5. Dept of Neurology Fondazione IRCCS C. Mondino, Mondino 2, Pavia 27100, Italy
6. Dept of Neurology ASST Papa Giovanni XXIII, Piazza OMS 1 24127 Bergamo, Italy
7. Dept. of Neurology Ospedale Valduce, Como, Dante Alighieri 11 22100 Como, Italy
8. Dept. of Neurology Ospedale di Saronno, ASST Valle olona, Piazzale Borella 1 Saronno 21047 (VA), Italy
9. Dept of Neurology Ospedale S. Antonio Abate Gallarate. Pastori 4 21013 Gallarate, Varese, Italy
10. Dept. of Neurology Ospedale di Desio (MB) Director, G. Mazzini 1 20832 Desio (MB), Italy
11. Dept. of Neurology ASST, Lecco-Ospedale A. Manzoni, dell’Eremo 9/11 23900 Lecco, Italy
12. Dept. of Neurology Ospedale di Cremona, ASST Cremona Director, le Concordia 1 26100 Cremona, Italy
13. Dept. of Neurology Ospedale Sant’Anna, Como, Ravona 20 22042 S, Fermo della Battaglia, Como, Italy
14. Dept. of Neurology Ospedale di Vimercate (MB), Santi Cosma e Damiano 10 20871 Vimercate (MB), Italy

ABSTRACT

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.

KEYWORDS

Emergency room, neurological diseases, neurology, workload.

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