Back to Search
Start Over
Increase in the admission of stroke mimics after change in emergency shifts
- Source :
- Cerebrovascular Diseases, Repositório Científico de Acesso Aberto de Portugal, Repositório Científico de Acesso Aberto de Portugal (RCAAP), instacron:RCAAP
- Publication Year :
- 2017
- Publisher :
- Karger, 2017.
-
Abstract
- © 2017 S. Karger AG, Basel<br />Background: In 2010, changes were made to the shift pattern of neurology residents for cover in the Emergency Department at a university hospital. This resulted in a decrease in the number of emergency hours worked by neurology specialists and allowed for a natural quasi-experiment. Aim: We aimed to evaluate if changes to the number of emergency hours worked by neurology residents and specialist neurologists, (intervention) altered the number or pattern of admitted stroke mimics (SMs). Methods: Observational retrospective study from January 2007 to December 2013. Time of intervention was set as August 2010. We used a segmented linear regression – ARIMA – to evaluate changes in the temporal pattern of admitted SMs. A statistical correlation between the number of emergency hours worked by neurology residents and the number of admitted SMs was calculated using the Pearson Correlation Coefficient. Results: Of the 2,552 patients admitted to the stroke unit, 290 were SMs (11.4%). After August 2010, there was an increase in the number of admitted SMs ( p = 0.003). After 2010, the most frequent SM diagnosis changed from a psychiatric condition to peripheral vertigo. A positive correlation was found between the number of hours worked primarily by neurology residents and the number of admitted SMs (Pearson correlation coefficient = 0.94; p = 0.002). Conclusions: Changes in the pattern of Emergency Department shifts were associated with an increase in the rate of admitted SMs and with a higher number of mimics with a final diagnosis of peripheral vertigo.
- Subjects :
- Male
Pediatrics
Neurology
Time Factors
030204 cardiovascular system & hematology
Hospitals, University
0302 clinical medicine
Patient Admission
Diagnosis
Thrombolytic Therapy
Practice Patterns, Physicians'
Stroke mimics
Stroke
Middle Aged
Predictive value of tests
Tissue Plasminogen Activator
Administration, Intravenous
Female
Cardiology and Cardiovascular Medicine
Emergency Service, Hospital
Adult
medicine.medical_specialty
Personnel Staffing and Scheduling
Workload
Expertise
Unnecessary Procedures
Diagnosis, Differential
03 medical and health sciences
Fibrinolytic Agents
Predictive Value of Tests
medicine
Humans
Neurologists
Diagnostic Errors
Aged
Retrospective Studies
Chi-Square Distribution
business.industry
Emergency department
Internship and Residency
Retrospective cohort study
medicine.disease
Models, Organizational
Emergency medicine
Linear Models
Observational study
Neurology (clinical)
business
Chi-squared distribution
030217 neurology & neurosurgery
Fibrinolytic agent
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Cerebrovascular Diseases, Repositório Científico de Acesso Aberto de Portugal, Repositório Científico de Acesso Aberto de Portugal (RCAAP), instacron:RCAAP
- Accession number :
- edsair.doi.dedup.....2d83104fbb1e6be516fbdb9afd693ce3