J Clin Neurol.  2016 Jan;12(1):93-100. 10.3988/jcn.2016.12.1.93.

Common Neurological Disorders Involving Inpatient Liaisons at a Secondary Referral Hospital in Taiwan: A Retrospective Cross-Sectional Study

• Liu CY
• Chiang HL
• Fu SC
• Su YC
• Hsiao CL
• Yang FY
• Lin SK

• KMID: 2364925
• DOI: http://doi.org/10.3988/jcn.2016.12.1.93

Abstract

BACKGROUND AND PURPOSE
The requirement for neurology liaison is increasing in accordance with the growing health care demands associated with aging populations. The aim of this study was to characterize the nature of neurological inpatient liaisons (NILs) to help plan for the appropriate use of neurology resources.
METHODS
This was a retrospective cross-sectional study of NILs in a secondary referral hospital over a 12-month period.
RESULTS
There were 853 neurological consultations with a liaison rate of 3% per admission case. Chest medicine, gastroenterology, and infectious disease were the three most frequent specialties requesting liaison, and altered consciousness, seizure, and stroke were the three most frequent disorders for which a NIL was requested. Infection was the most common cause of altered consciousness. Epilepsy, infection, and previous stroke were common causes of seizure disorders. Acute stroke accounted for 44% of all stroke disorders. Electroencephalography was the most recommended study, and was also the most frequently performed. Ninety-five percent of emergency consultations were completed within 2 hours, and 85% of regular consultations were completed within 24 hours. The consult-to-visit times for emergency and regular consultations were 44+/-47 minutes (mean+/-standard deviation) and 730+/-768 minutes, respectively, and were shorter for regular consultations at intensive care units (p=0.0151) and for seizure and stroke disorders (p=0.0032).
CONCLUSIONS
Altered consciousness, seizure, and stroke were the most common reasons for NILs. Half of the patients had acute neurological diseases warranting immediate diagnosis and treatment by the consulting neurologists. Balancing increasing neurologist workloads and appropriate health-care resources remains a challenge.

Keyword

consultation; liaison; inpatient; neurology

MeSH Terms

Aging
Communicable Diseases
Consciousness
Cross-Sectional Studies*
Delivery of Health Care
Diagnosis
Electroencephalography
Emergencies
Epilepsy
Gastroenterology
Humans
Inpatients*
Intensive Care Units
Nervous System Diseases*
Neurology
Referral and Consultation
Retrospective Studies*
Secondary Care Centers*
Seizures
Stroke
Taiwan*
Thorax

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