Department of Clinical Neurosciences, The University of Edinburgh, Western General Hospital, Edinburgh, UK; Edinburgh Spinal Surgery Outcome Studies Group, UK.
Department of Clinical Neurosciences, The University of Edinburgh, Western General Hospital, Edinburgh, UK; Centre for Clinical Brain Sciences, The University of Edinburgh, UK; Edinburgh Spinal Surgery Outcome Studies Group, UK.
Surgeon. 2020 Feb;18(1):8-11. doi: 10.1016/j.surge.2019.03.005. Epub 2019 Apr 26.
We assessed the documentation rates of signs and symptoms, including sexual function, in patients with suspected cauda equina syndrome and whether they can be improved by increasing local awareness.
We reviewed all electronic records of patients referred with suspected CES who required urgent MRI to our regional service over a 2 month period. We recorded the documentation rates of clinical signs and symptoms. The results were presented locally to increase awareness. A further 2 month period was then re-audited. 120 patients in total were included across both time periods. Chi-squared was used to compare documentation rates between time periods.
25 of 120 patients had radiological cauda equina compression. Lower limb neurology, urinary function and saddle sensation were almost universally documented. After the intervention, there was a significant increase (p < 0.05) in the documentation of bowel function and post-void residual but not sexual function. Sexual function was poorly documented with rates of 3% and 11% throughout the two audited periods.
Certain clinical features of CES are well documented. Increasing awareness may improve documentation of certain symptoms/signs in patients with suspected cauda equina syndrome. Sexual function was poorly documented and increasing awareness alone is an inadequate intervention.
我们评估了疑似马尾综合征患者的体征和症状（包括性功能）的记录率，并探讨通过提高当地认识是否可以提高记录率。
我们回顾了在两个月的时间内，因疑似 CES 而被转诊至我们区域性服务的需要紧急 MRI 的所有患者的电子病历。我们记录了临床体征和症状的记录率。结果在当地进行了汇报以提高认识。然后对另一个为期两个月的时间进行了重新审核。两个时间段共纳入了 120 名患者。使用卡方检验比较两个时间段的记录率。
120 名患者中有 25 名患有放射学马尾压迫。下肢神经功能、尿功能和鞍区感觉几乎普遍得到记录。干预后，大便功能和残余尿量的记录明显增加（p<0.05），但性功能没有增加。性功能记录不佳，两个审核时间段的记录率分别为 3%和 11%。
某些 CES 的临床特征记录良好。提高认识可能会提高疑似马尾综合征患者某些症状/体征的记录率。性功能记录不佳，仅提高认识是不够的干预措施。
