Topka H, Pfefferkorn T, Andres F, Kastrup A, Klein M, Niesen W, Poppert H
Klinik für Neurologie, Klinische Neurophysiologie, Neuropsychologie und Stroke Unit, Klinikum Bogenhausen, Städtisches Klinikum München GmbH, Englschalkinger Str. 77, 81925, München, Deutschland.
Klinik für Neurologie, Klinikum Ingolstadt GmbH, Ingolstadt, Deutschland.
Nervenarzt. 2017 Jun;88(6):625-634. doi: 10.1007/s00115-017-0343-x.
In 2007, the first poll among neurologists provided some insight into the organizational structures of emergency neurology in Germany. Given that emergency neurology as well as emergency medicine in general have undergone substantial changes during the last decade, the subcommittee Neurological Emergency Medicine of the German Neurological Society conducted a follow-up study to explore current structures supporting neurological emergency medicine in German neurological hospitals. Between July and September 2016, an online questionnaire was e‑mailed to 675 neurologists in institutions participating in in-patient neurological care. Of these, some 32% (university hospitals 49%) answered. Neurological patients represent 12-16% and hence a significant proportion of emergency patients. The fraction of in-patients admitted to hospitals via emergency departments amounted to 78% (median) in general hospitals and 52% in university hospitals. Most emergency departments are organized as an interdisciplinary structure combining conservative with surgical disciplines frequently led by an independent department head. Neurology departments employ rather diverse strategies to organize neurological emergency care. Also, the way emergency patients are assigned to different disciplines varied largely. Currently, neurological patients represent a rather growing fraction of patients in emergency departments. An increasing proportion of neurology in-patients enter the hospital via emergency departments. Neurology departments in Germany face increasing challenges to cope with large numbers of neurological emergency patients. While most of the participating neurologists indicated suffering predominantly from scarce personal resources both in neurology and neuroradiology, an independent neurological emergency department was not considered an option.
2007年，首次针对神经科医生的调查对德国急诊神经病学的组织结构有了一定了解。鉴于急诊神经病学以及一般的急诊医学在过去十年中发生了重大变化，德国神经病学协会的神经急诊医学小组委员会进行了一项后续研究，以探索德国神经病学医院中支持神经急诊医学的现有结构。2016年7月至9月期间，一份在线问卷通过电子邮件发送给了参与住院神经病学护理的机构中的675名神经科医生。其中，约32%（大学医院为49%）做出了回复。神经科患者占急诊患者的12% - 16%，因此是相当大的一部分。综合医院中通过急诊科入院的住院患者比例一般为78%（中位数），大学医院为52%。大多数急诊科采用跨学科结构组织，将保守学科与外科学科相结合，通常由独立的科室主任领导。神经科采用了相当多样的策略来组织神经急诊护理。此外，将急诊患者分配到不同学科的方式差异很大。目前，神经科患者在急诊科患者中所占比例呈上升趋势。越来越多的神经科住院患者通过急诊科入院。德国的神经科面临着应对大量神经急诊患者的日益增加的挑战。虽然大多数参与调查的神经科医生表示主要受神经科和神经放射科人力资源稀缺的困扰，但设立独立的神经急诊科并非一个可行的选择。
