Emergency Department Neurosurgical Consultations in a Tertiary Care Hospital

Yıl 2023, Cilt: 15 Sayı: 3, 412 - 416, 20.10.2023

Erdinç Şengüldür Kudret Selki Cengiz Tuncer Mehmet Cihat Demir

https://doi.org/10.18521/ktd.1360048

Öz

Objective: To reveal the characteristics of patients needing neurosurgery by examining neurosurgery consultations within the emergency department (ED) admissions of a tertiary academic hospital.
Method: This is a retrospective, single-centre observational study. Patients admitted to the ED between 01.01.2022 and 31.12.2022 and consulted to the neurosurgery department were identified through the hospital computer system and included in the study. The demographic information of the patients, mode of admission to the ED, the reasons for admission, the time of admission, the number of brain computed tomography (CT) scans, whether they underwent surgery or not, and the mortality results were recorded.
Results: A total of 441 neurosurgery consultations were examined. Fall 35.6% (n=157) and traffic accident 16.6% (n=73) were the most common reasons for consultation. It was observed that 92.5% (n=408) of the patients had a brain CT scan, and 19.5% (n=86) had two or more brain CTs. It was determined that 12.7% (n=56) of the patients consulted for neurosurgery were operated on, and 4.1% (n=18) of the patients' hospital admissions resulted in death. Only 53.7% (n=237) of the patients who underwent neurosurgery consultation were discharged from the ED. It was determined that significantly more Neurosurgery consultations were requested during working hours (p = 0.013)
Conclusion: Most consultation calls from the ED to neurosurgery are for trauma patients. Brain CT examination is frequently used in neurosurgical patient evaluation. As a result of the consultations, almost half of the patients are hospitalized. Emergency physicians can select patients who need neurosurgery well.

Anahtar Kelimeler

Emergency Department, Neurosurgery, Consultation

Üçüncü Basamak Bir Hastanede Acil Servis Nöroşirurji Konsültasyonları

Öz

Amaç: Üçüncü basamak akademik bir hastanenin acil servis başvuruları içerisindeki nöroşirürji konsultasyonlarının incelenerek nöroşirürji ihtiyacı olan hastaların özelliklerinin ortaya konulması amaçlandı.
Metod: Bu retrospektif, tek merkezli gözlemsel bir çalışmadır. 01.01.2022 – 31.12.2022 tarihleri arasında acil servise başvuran ve acil servisten beyin cerrahi bölümüne konsulte edilen hastalar hastane bilgi işlem sistemi üzerinden tespit edilip çalışmaya dahil edildi. Hastaların demografik bilgileri, hastaneye başvuru şekilleri, başvuru nedenleri, başvuru saatleri, çekilen beyin bilgisayarlı tomografi (BT) sayıları, ameliyat olup olmadıkları ve mortalite sonuçları kaydedildi.
Bulgular: Acil servisten bir senede toplamda 441 nöroşirürji konsültasyonu yapıldı. Düşme %35,6 (n=157) ve trafik kazası %16,6 (n=73) en sık konsültasyon sebepleriydi. Hastaların %92,5 (n=408) ‘ine beyin BT çekildiği, %19,5 (n=86) hastaya ise 2 ya da daha çok beyin BT tetkiki yapıldığı görüldü. Nöroşirürjiye konsulte edilen hastaların %12,7 (n=56) ‘sının ameliyat edildiği, %4,1 (n=18) ‘inin hastane başvurusunun eksitus ile sonuçlandığı saptandı. Nöroşirürji konsültasyonu yapılan hastaların sadece %53,7 (n=237) ’si acil servisten taburcu oldu. Mesai saatleri içerisinde anlamlı olarak daha fazla Nöroşirürji konsültasyonu yapıldığı tespit edildi (p=0.013).
Sonuç: Acil servisten nöroşirürjiye yapılan konsültasyon çağrılarının büyük çoğunluğu travma hastaları içindir. Nöroşirürjik hasta değerlendirmesinde sıklıkla beyin BT tetkikinden yararlanılmaktadır. Yapılan konsültasyonlar sonucunda hastaların neredeyse yarısı hastaneye yatırılmaktadır. Acil servis hekimleri nöroşirürji ihtiyacı olan hastaların ayrımını iyi yapabilmektedir.

Anahtar Kelimeler

Acil Servis, Nöroşirürji, Konsültasyon

Kaynakça

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