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Neurological Emergencies in Patients Hospitalized With Nonneurological Illness
- Title
- Neurological Emergencies in Patients Hospitalized With Nonneurological Illness
- Authors
- Jeon, Sang-Boom; Lee, Han-Bin; Koo, Yong Seo; Lee, Hyunjo; Lee, Jung Hwa; Park, Bobin; Choi, Soh Hyun; Jeong, Suyeon; Chang, Jun Young; Hong, Sang-Burn; Lim, Chae-Man; Lee, Sang-Ahm
- Ewha Authors
- 이정화
- SCOPUS Author ID
- 이정화
- Issue Date
- 2021
- Journal Title
- JOURNAL OF PATIENT SAFETY
- ISSN
- 1549-8417
1549-8425
- Citation
- JOURNAL OF PATIENT SAFETY vol. 17, no. 8, pp. E1332 - E1340
- Keywords
- brain; nervous system disease; emergencies; hospital rapid response team; hospital mortality; ACDU = Alert; Confused; Drowsy; Unresponsive; CI = confidence interval; CT = computed tomography; EEG = electroencephalography; GOS = Glasgow Outcome Scale; ICU = intensive care unit; MRI = magnetic resonance imaging; NAT = neurological alert team
- Publisher
- LIPPINCOTT WILLIAMS &
WILKINS
- Indexed
- SCIE; SSCI; SCOPUS
- Document Type
- Article
- Abstract
- Objective We aimed to present neurological profiles and clinical outcomes of patients with acute neurological symptoms, which developed during hospitalization with nonneurological illness. Methods We organized the neurological alert team (NAT), a neurological rapid response team, to manage in-hospital neurological emergencies. In this registry-based study, we analyzed the clinical profiles and outcomes of patients who were consulted to the NAT. We also compared the 3-month mortality of patients with acute neurological symptoms with that of patients without acute neurological symptoms. Results Among the 85,507 adult patients, 591 (0.7%) activated the NAT. The most common reason for NAT activation was stroke symptoms (37.6%), followed by seizures (28.6%), and sudden unresponsiveness (24.0%). The most common diagnosis by the NAT neurologists was metabolic encephalopathy (45.5%), followed by ischemic stroke (21.2%) and seizures or status epilepticus (21.0%). Patients with NAT activation had high rates in mortality before hospital discharge (22.5%) and at 3 months (34.7%), transfer to intensive care units (39.6%), and length of hospital stay (43.1 +/- 57.1 days). They also had high prevalence of poor functional status (78.1%) and recurrence of neurological symptoms at 3 months (27.2%). In a Cox proportional hazards model, patients with in-hospital neurological emergencies had a hazard ratio of 13.2 in terms of mortality at 3 months (95% confidence interval, 11.5-15.3; P < 0.001). Conclusions Occurrence of acute neurological symptoms during hospital admission was associated with high rate of mortality and poor functional status. These results call for enhanced awareness and hospital-wide strategies for managing in-hospital neurological emergencies.
- DOI
- 10.1097/PTS.0000000000000682
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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