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Triaging Herpes Zoster Ophthalmicus Patients in the Emergency Department: Do All Patients Require Referral? Adam et al. TRIAGING HERPES ZOSTER OPHTHALMICUS PATIENTS IN THE ED.
- Source :
- Academic Emergency Medicine; Nov2010, Vol. 17 Issue 11, p1183-1188, 6p, 2 Diagrams, 2 Charts
- Publication Year :
- 2010
-
Abstract
- The objective was to assess the predictive value of clinical signs and symptoms of herpes zoster ophthalmicus (HZO) for development of moderate to severe eye disease. This was a prospective cohort multicenter study of 54 patients referred to the ophthalmology service after presenting to the emergency department (ED) or primary care clinic with a zosteriform rash of less than 10 days' duration. Upon referral to ophthalmology, easily assessable clinical signs and symptoms were documented. A complete ocular exam was then performed. Patients were followed for 2 months. Twenty-three patients (43%) developed moderate to severe disease as defined by corneal or intraocular involvement. Eye redness and rash in the supratrochlear nerve distribution had a statistically significant association with clinically relevant eye disease. All 23 patients who developed moderate to severe eye disease presented with a red eye. Hutchinson's sign (nasociliary nerve involvement) was not predictive of clinically relevant eye disease. Eye redness was 100% sensitive for predicting moderate to severe eye disease in this sample of patients and should necessitate immediate referral for ophthalmologic assessment. Patients lacking eye redness, even with a positive Hutchinson's sign, may not require immediate specialist consultation. All patients not being referred require careful instructions to seek further care should they develop any concerning eye symptoms such as redness, pain, photophobia, or visual disturbance. ACADEMIC EMERGENCY MEDICINE 2010; 17:1183-1188 © 2010 by the Society for Academic Emergency Medicine [ABSTRACT FROM AUTHOR]
- Subjects :
- ANALYSIS of variance
CHI-squared test
COMPUTER software
DECISION trees
EMERGENCY medical services
HOSPITAL emergency services
LONGITUDINAL method
MEDICAL cooperation
MEDICAL referrals
HEALTH outcome assessment
PATIENTS
PRIMARY health care
QUESTIONNAIRES
RESEARCH
SCALE analysis (Psychology)
MEDICAL triage
LOGISTIC regression analysis
OPHTHALMIC zoster
DATA analysis
SCALE items
PAIN measurement
PREDICTIVE validity
SEVERITY of illness index
SYMPTOMS
DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 10696563
- Volume :
- 17
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Academic Emergency Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 54952264
- Full Text :
- https://doi.org/10.1111/j.1553-2712.2010.00875.x