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神经科会诊的临床与流行病学特征:何时需要进行神经科评估。

Clinical and Epidemiological Characterization of Neurological Consults: When a Neurological Evaluation Is Requested.

作者信息

Corrêa Karin Mitiyo, de Rezende Filho Flávio Moura, Abrantes Fabiano Ferreira, de Andrade João Brainer Clares, Barsottini Orlando G P, Pedroso José Luiz

机构信息

Department of Neurology, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Neurohospitalist. 2021 Apr;11(2):114-118. doi: 10.1177/1941874420972305. Epub 2020 Nov 23.

Abstract

BACKGROUND AND OBJECTIVES

Medical consultation by a specialist physician consists of an evaluation to review diagnosis and management of patients with some neurological conditions referred from other specialty wards. This mode of care delivery has gained relevance in the field of neurology and adequate training on it is valuable, allowing neurologists to provide state-of-the-art management to patients with neurological manifestations. The present study aimed to characterize neurology consults and to discuss the roles of the neurologist within a hospital setting.

METHODS

A prospective analysis of neurological consultations provided to inpatients of a university hospital in São Paulo, Brazil, was performed from September 2016 to September 2017. These patients were followed by the principal investigator, who was not involved in their care.

RESULTS

We evaluated data from 117 female and 106 male inpatients with a mean age of 53.8 ± 2.4. The medical specialties that most frequently requested neurological consultations were Internal Medicine (17%), Cardiology (11.2%) and Pulmonology (9.4%). The main reasons for a neurology consultation request were seizures (15.6%); decreased level of consciousness (8.9%) and confusion (7.1%). The most frequent diagnosis in patients receiving a neurology consult were stroke (10.2%); hypoxic-ischemic encephalopathy (5.3%) and sepsis (2.2%).

CONCLUSION

Our findings show the growing importance of the role of neurologists within hospital settings as many medical conditions present with neurological manifestations and the significance of the neurohospitalist model of care.

摘要

背景与目的

专科医生进行的医学会诊包括对从其他专科病房转诊来的患有某些神经系统疾病的患者进行诊断评估和管理。这种护理模式在神经病学领域已变得越来越重要,对此进行充分培训很有价值,能使神经科医生为有神经症状的患者提供最先进的治疗。本研究旨在描述神经病学会诊的特征,并讨论神经科医生在医院环境中的作用。

方法

对2016年9月至2017年9月期间巴西圣保罗一家大学医院住院患者的神经病学会诊进行前瞻性分析。这些患者由主要研究者进行随访,研究者未参与他们的治疗。

结果

我们评估了117名女性和106名男性住院患者的数据,平均年龄为53.8±2.4岁。最常请求神经病学会诊的医学专科是内科(17%)、心脏病学(11.2%)和肺病学(9.4%)。请求神经病学会诊的主要原因是癫痫发作(15.6%);意识水平下降(8.9%)和意识模糊(7.1%)。接受神经病学会诊患者中最常见的诊断是中风(10.2%);缺氧缺血性脑病(5.3%)和败血症(2.2%)。

结论

我们的研究结果表明,由于许多疾病都伴有神经症状,神经科医生在医院环境中的作用日益重要,并显示了神经专科住院医师护理模式的重要性。

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