Author Topic: (Abst.) Triaging patients w/MS in the emergency department: Room for improvement  (Read 37 times)

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Offline agate

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From PubMed, December 23, 2017:

Quote
Int J MS Care. 2017 Nov-Dec;19(6):290-296.

Triaging Patients with Multiple Sclerosis in the Emergency Department: Room for Improvement

Abboud H, Mente K, Seay M, Kim J, Ali A, Bermel R, Willis MA.

BACKGROUND:

Patients with multiple sclerosis (MS) present to the emergency department (ED) for various reasons. Although true relapse is rarely the underlying culprit, ED visits commonly result in new magnetic resonance imaging (MRI) and neurology admissions. We studied ED visits in patients with MS and evaluated decision making regarding diagnostic/therapeutic interventions and visit outcomes. We identified potential areas for improvement and used the data to propose a triaging algorithm for patients with MS in the ED.

METHODS:

We reviewed the medical records from 176 ED visits for patients with MS in 2014.

RESULTS:

Ninety-seven visits in 75 patients were MS related (66.6% female; mean SD age, 52.6 13.8 years; mean SD disease duration, 18.5 10.5 years). Thirty-three visits were for new neurologic symptoms (category 1), 29 for worsening preexisting symptoms (category 2), and 35 for MS-related complications (category 3). Eighty-nine visits (91.8%) resulted in hospital admission (42.7% to neurology). Only 39% of ordered MRIs showed radiographic activity. New relapses were determined in 27.8% of the visits and were more prevalent in category 1 compared with category 2 (P = .003); however, the two categories had similar rates of ordered MRIs and neurology admissions.

CONCLUSIONS:

New relapse is a rare cause of ED visits in MS. Unnecessary MRIs and neurology admissions can be avoided by developing a triaging system for patients with MS based on symptom stratification.

https://www.ncbi.nlm.nih.gov/pubmed/29270086
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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