We retrospectively analysed patients seen in a rapid referral clinic to identify those with abnormalities genuinely requiring urgent assessment, and to evaluate the impact of the clinic on routine services.
After advertising the availability of the service, 25% of telephone referrals from primary-care physicians led to identification of patients considered suitable for urgent evaluation.
We assessed 350 patients over an 18-month period.
After neurological review, relevant abnormalities were identified in 73%, and 33% were considered to have warranted urgent assessment.
In addition, 74% required radiological evaluation and 14% had a neurophysiological procedure ; 19.4% were admitted on the same day, 13% underwent CSF analysis and 34% required some form of therapeutic intervention.
In retrospect, patients with a clinical history of>11 days rarely warranted urgent referral.
Visual failure and diplopia provided the highest correlation with patients deemed to require urgent assessment, and syncope and headache the lowest.
Despite the number of patients reviewed, no effect was demonstrated on waiting times for standard out-patient review.
Mots-clés Pascal : Neurologie, SAMU, Etude longitudinale, Exploration clinique, Diagnostic, Evaluation, Facteur risque, Homme, Méthodologie, Royaume Uni, Europe, Système nerveux pathologie, Organisation santé
Mots-clés Pascal anglais : Neurology, Emergency medical care unit, Follow up study, Clinical investigation, Diagnosis, Evaluation, Risk factor, Human, Methodology, United Kingdom, Europe, Nervous system diseases, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0217697
Code Inist : 002B17I. Création : 11/09/1998.