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儿科神经科急诊就诊情况:儿科神经科医生建议的描述和使用。

Pediatric emergency room visits for neurological conditions: Description and use of pediatric neurologist advice.

机构信息

Service de neurologie pédiatrique, APHM, CHU de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France.

Urgences pédiatriques, APHM, CHU de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France.

出版信息

Arch Pediatr. 2020 Nov;27(8):416-422. doi: 10.1016/j.arcped.2020.09.005. Epub 2020 Oct 23.

Abstract

INTRODUCTION AND OBJECTIVE

Information on the spectrum and frequencies of pediatric neurological presentations to emergency departments is vital to optimize quality of care. The objective of this study was to determine the incidence of pediatric neurological emergencies and to analyze the impact of specialist neurological advice in emergency care.

PATIENTS AND METHODS

We performed a retrospective descriptive study of pediatric emergency room visits for neurological reasons at the Timone University Hospital in Marseille over a 6-month period (from October 2017 to March 2018).

RESULTS

Of the 14,572 emergencies analyzed, 370 (2.5%) were for neurological conditions. These were most commonly seizures (56.7% of cases), headache (19.7%), and motor or sensory deficits (5.1%). The most frequent diagnosis was epileptic seizure (30%), followed by febrile seizure (26.1%) and migraine (15%). Around two in every five patients (37.6%) required hospitalization. Neurological emergencies requiring critical care occurred at a frequency of about one per month (1.6% of cases). A pediatric neurologist was consulted in 37.3% of cases, resulting in a modification of the diagnosis or treatment in 66% of these referrals.

CONCLUSION

The results of this study suggest that a formal referral system between the emergency department and pediatric neurologists would be useful.

摘要

简介与目的

了解儿科神经科急诊的表现谱和频率对于优化医疗质量至关重要。本研究的目的是确定儿科神经科急症的发生率,并分析专科神经科意见对急诊护理的影响。

患者与方法

我们对马赛提蒙大学医院(Timone University Hospital)儿科急诊因神经原因就诊进行了为期 6 个月(2017 年 10 月至 2018 年 3 月)的回顾性描述性研究。

结果

在分析的 14572 例急诊中,有 370 例(2.5%)为神经科疾病。这些疾病最常见的是癫痫发作(56.7%)、头痛(19.7%)和运动或感觉障碍(5.1%)。最常见的诊断是癫痫发作(30%),其次是热性惊厥(26.1%)和偏头痛(15%)。每五个患者中约有两个(37.6%)需要住院治疗。需要重症监护的神经科急症的发生频率约为每月一次(1.6%)。在 37.3%的病例中咨询了儿科神经科医生,其中 66%的转介病例对诊断或治疗进行了修改。

结论

本研究结果表明,急诊和儿科神经科医生之间建立正式的转诊系统将是有益的。

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