Araştırma Makalesi
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A comprehensive retrospective review of ınpatient hematology consultations at a tertiary care hospital

Yıl 2024, Cilt: 15 Sayı: 4, 633 - 641, 31.12.2024
https://doi.org/10.18663/tjcl.1588403

Öz

Aim: Hematological parameters are affected by many hematological and non-hematological reasons. In many diseases, values that go beyond normal limits are often a reason for consultation by physicians in other branches of science. In our study, what consultations are requested from hematology in patients hospitalized in our hospital, the most common hematological problems encountered by the departments, and the results of the consultations were examined.
Material and Methods: A total of 684 consultations were retrospectively scanned between 2022 and 2023, based on the information obtained from the hospital data system. The study examined the requesting department, consultation reason, patients’ comorbid conditions, history of hematologic disorders, hematologic and non-hematologic diagnoses following the consultation, and assessments using peripheral smears and biopsies.
Results: 59.50% of the consultations were requested from internal departments, while 40.50% were requested from surgical departments. The most common reason for requesting consultation was found to be cytopenias with 41.96%. The most common reason for consultation requested for cytopenia was thrombocytopenia. While 45.50% of the consultations were evaluated with peripheral smear, 10.20% were evaluated with bone marrow biopsy.
Conclusion: We determined the issues on which physicians in other departments most frequently felt the need for consultation, how many of these resulted in a hematological diagnosis, and the non-hematological diagnoses that most affected blood parameters. We believe that the results of our study will be guiding in training programs and preparation of consultation books.

Kaynakça

  • Braam A, Buljac-Samardzic M, Hilders C, and van Wijngaarden JDH. Collaboration Between Physicians from Different Medical Specialties in Hospital Settings: A Systematic Review. J Multidiscip Healthc. 2022;15:2277-300.
  • Cortazzo JM, Guertler AT, and Rice MM. Consultation and referral patterns from a teaching hospital emergency department. Am J Emerg Med. 1993;11(5):456-9.
  • Peeters K, Giroldi E, Veldhuizen L, Abdelaziz K, Muris D, and Cals J. General Practitioner Use of e-Consultation to Consult Hospital Specialists: Interview Study to Obtain Physician's Perceptions About Digital Interprofessional Communication. J Med Internet Res. 2023;25:e40318.
  • Vimalananda VG, Gupte G, Seraj SM, et al. Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis. J Telemed Telecare. 2015;21(6):323-30.
  • Ahmed S, Kelly YP, Behera TR, et al. Utility, Appropriateness, and Content of Electronic Consultations Across Medical Subspecialties. Ann Intern Med. 2020;172(10):641-47.
  • Deldar K, Bahaadinbeigy K, and Tara SM. Teleconsultation and Clinical Decision Making: a Systematic Review. Acta Inform Med. 2016;24(4):286-92.
  • Voaklander B, Gaudet LA, Kirkland SW, Keto-Lambert D, Villa-Roel C, and Rowe BH. Interventions to improve consultations in the emergency department: A systematic review. Acad Emerg Med. 2022;29(12):1475-95.
  • Raymundo DU, Dalio MB, Ribeiro MS, and Joviliano EE. Inpatient consultations with the vascular and endovascular surgery team at an academic tertiary hospital. J Vasc Bras. 2022;21:e20210159.
  • Venkatesh RD, Campbell EJ, Thiim M, et al. e-Consults in gastroenterology: An opportunity for innovative care. J Telemed Telecare. 2019;25(8):499-505.
  • Miloslavsky EM and Chang Y. Development and Evaluation of a Novel Survey Tool Assessing Inpatient Consult Service Performance. J Grad Med Educ. 2017;9(6):759-62.
  • Parikh PJ, Mowrey C, Gallimore J, Harrell S, and Burke B. Evaluating e-consultation implementations based on use and time-line across various specialties. Int J Med Inform. 2017;108:42-48.
  • Lee RS, Woods R, Bullard M, Holroyd BR, and Rowe BH. Consultations in the emergency department: a systematic review of the literature. Emerg Med J. 2008;25(1):4-9.
  • Leithead CC, Matthews TC, Pearce BJ, et al. Analysis of emergency vascular surgery consults within a tertiary health care system. J Vasc Surg. 2016;63(1):177-81.
  • Neuhaus K, Ho ES, Low N, and Forrest CR. Analysis of Plastic Surgery Consultations in a High-Volume Paediatric Emergency Department: A Quality Improvement Initiative. Plast Surg (Oakv). 2021;29(4):272-79.
  • Sullivan JF, Forde JC, Creagh TA, et al. A review of inpatient urology consultations in an Irish tertiary referral centre. Surgeon. 2013;11(6):300-3.
  • England RW, Ho TC, Napoli DC, and Quinn JM. Inpatient consultation of allergy/immunology in a tertiary care setting. Ann Allergy Asthma Immunol. 2003;90(4):393-7.
  • O'Malley NT, O'Daly B, Harty JA, and Quinlan W. Inpatient consultations to an orthopaedic service: the hidden workload. Ir J Med Sci. 2011;180(4):855-8.
  • Brick C, Lowes J, Lovstrom L, et al. The impact of consultation on length of stay in tertiary care emergency departments. Emerg Med J. 2014;31(2):134-8.
  • Beckerleg W, Wooller K, and Hasimjia D. Interventions to reduce emergency department consultation time: A systematic review of the literature. Cjem. 2020;22(1):56-64.
  • Serling-Boyd N and Miloslavsky EM. Enhancing the Inpatient Consultation Learning Environment to Optimize Teaching and Learning. Rheum Dis Clin North Am. 2020;46(1):73-83.
  • Rutsky J, Schumacher D, and Mallon D. Relevance, quick hits, and vibe: Features of meaningful teaching and learning during trainee consult interactions. J Hosp Med. 2024;19(1):24-30.
  • Chen DC, Miloslavsky EM, Winn AS, and McSparron JI. Fellow as Clinical Teacher (FACT) Curriculum: Improving Fellows' Teaching Skills During Inpatient Consultation. MedEdPORTAL. 2018;14:10728.
  • Ta K and Gardner GC. Evaluation of the activity of an academic rheumatology consult service over 10 years: using data to shape curriculum. J Rheumatol. 2007;34(3):563-6.
  • Burwick N, Stein J, Garcia DA, Broudy VC, and Richard RE. Monoclonal gammopathies: Electronic subspecialty consultation. Eur J Haematol. 2018;100(4):351-55.
  • Su DG, Rehman S, Wang K, et al. Outcomes Following Implementation of an Electronic Model for Perioperative Hematologic Consultation. J Surg Res. 2024;301:10-17.
  • Dosani T, Xiang J, Wang K, et al. Impact of Hematology Electronic Consultations on Utilization of Referrals and Patient Outcomes in an Integrated Health Care System. JCO Oncol Pract. 2022;18(4):e564-e73.

Üçüncü basamak bir hastanede yatan hastalarda hematoloji konsültasyonlarının kapsamlı retrospektif incelemesi

Yıl 2024, Cilt: 15 Sayı: 4, 633 - 641, 31.12.2024
https://doi.org/10.18663/tjcl.1588403

Öz

Amaç: Hematolojik parametreler, birçok hematolojik ve hematolojik olmayan nedenle etkilenmektedir. Birçok hastalıkta, normal sınırlar dışına çıkan değerler diğer tıp branşlarındaki hekimler tarafından sıklıkla konsültasyon talep edilmesine neden olmaktadır. Bu çalışmada, hastanemizde yatan hastalarda hematolojiden hangi konsültasyonların istendiği, bölümler tarafından en sık karşılaşılan hematolojik problemler ve konsültasyon sonuçları incelenmiştir.
Gereç ve Yöntemler: 2022-2023 yılları arasında toplam 684 konsültasyon, hastane veri sistemi üzerinden retrospektif olarak tarandı. Çalışmada, konsültasyonu talep eden bölüm, konsültasyon nedeni, hastaların komorbid durumları, hematolojik hastalık öyküsü, konsültasyon sonrası hematolojik ve hematolojik olmayan tanılar, periferik yayma ve biyopsi ile yapılan değerlendirmeler incelendi.
Bulgular: Konsültasyonların %59.50'si dahili bölümlerden, %40.50'si cerrahi bölümlerden talep edildi. Konsültasyon talep etme nedenleri arasında en yaygın neden, %41.96 ile sitopeniler olarak bulundu. Sitopeni için talep edilen en sık konsültasyon nedeni trombositopeni idi. Konsültasyonların %45.50’si periferik yayma ile, %10.20’si kemik iliği biyopsisi ile değerlendirildi.
Sonuçlar: Diğer bölümlerdeki hekimlerin hangi konularda en sık konsültasyona ihtiyaç duyduğunu, bunlardan kaçının hematolojik tanı ile sonuçlandığını ve kan parametrelerini en çok etkileyen hematolojik olmayan tanıları belirledik. Çalışmamızın sonuçlarının eğitim programlarında ve konsültasyon kitaplarının hazırlanmasında yön verici olacağı kanaatindeyiz.

Kaynakça

  • Braam A, Buljac-Samardzic M, Hilders C, and van Wijngaarden JDH. Collaboration Between Physicians from Different Medical Specialties in Hospital Settings: A Systematic Review. J Multidiscip Healthc. 2022;15:2277-300.
  • Cortazzo JM, Guertler AT, and Rice MM. Consultation and referral patterns from a teaching hospital emergency department. Am J Emerg Med. 1993;11(5):456-9.
  • Peeters K, Giroldi E, Veldhuizen L, Abdelaziz K, Muris D, and Cals J. General Practitioner Use of e-Consultation to Consult Hospital Specialists: Interview Study to Obtain Physician's Perceptions About Digital Interprofessional Communication. J Med Internet Res. 2023;25:e40318.
  • Vimalananda VG, Gupte G, Seraj SM, et al. Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis. J Telemed Telecare. 2015;21(6):323-30.
  • Ahmed S, Kelly YP, Behera TR, et al. Utility, Appropriateness, and Content of Electronic Consultations Across Medical Subspecialties. Ann Intern Med. 2020;172(10):641-47.
  • Deldar K, Bahaadinbeigy K, and Tara SM. Teleconsultation and Clinical Decision Making: a Systematic Review. Acta Inform Med. 2016;24(4):286-92.
  • Voaklander B, Gaudet LA, Kirkland SW, Keto-Lambert D, Villa-Roel C, and Rowe BH. Interventions to improve consultations in the emergency department: A systematic review. Acad Emerg Med. 2022;29(12):1475-95.
  • Raymundo DU, Dalio MB, Ribeiro MS, and Joviliano EE. Inpatient consultations with the vascular and endovascular surgery team at an academic tertiary hospital. J Vasc Bras. 2022;21:e20210159.
  • Venkatesh RD, Campbell EJ, Thiim M, et al. e-Consults in gastroenterology: An opportunity for innovative care. J Telemed Telecare. 2019;25(8):499-505.
  • Miloslavsky EM and Chang Y. Development and Evaluation of a Novel Survey Tool Assessing Inpatient Consult Service Performance. J Grad Med Educ. 2017;9(6):759-62.
  • Parikh PJ, Mowrey C, Gallimore J, Harrell S, and Burke B. Evaluating e-consultation implementations based on use and time-line across various specialties. Int J Med Inform. 2017;108:42-48.
  • Lee RS, Woods R, Bullard M, Holroyd BR, and Rowe BH. Consultations in the emergency department: a systematic review of the literature. Emerg Med J. 2008;25(1):4-9.
  • Leithead CC, Matthews TC, Pearce BJ, et al. Analysis of emergency vascular surgery consults within a tertiary health care system. J Vasc Surg. 2016;63(1):177-81.
  • Neuhaus K, Ho ES, Low N, and Forrest CR. Analysis of Plastic Surgery Consultations in a High-Volume Paediatric Emergency Department: A Quality Improvement Initiative. Plast Surg (Oakv). 2021;29(4):272-79.
  • Sullivan JF, Forde JC, Creagh TA, et al. A review of inpatient urology consultations in an Irish tertiary referral centre. Surgeon. 2013;11(6):300-3.
  • England RW, Ho TC, Napoli DC, and Quinn JM. Inpatient consultation of allergy/immunology in a tertiary care setting. Ann Allergy Asthma Immunol. 2003;90(4):393-7.
  • O'Malley NT, O'Daly B, Harty JA, and Quinlan W. Inpatient consultations to an orthopaedic service: the hidden workload. Ir J Med Sci. 2011;180(4):855-8.
  • Brick C, Lowes J, Lovstrom L, et al. The impact of consultation on length of stay in tertiary care emergency departments. Emerg Med J. 2014;31(2):134-8.
  • Beckerleg W, Wooller K, and Hasimjia D. Interventions to reduce emergency department consultation time: A systematic review of the literature. Cjem. 2020;22(1):56-64.
  • Serling-Boyd N and Miloslavsky EM. Enhancing the Inpatient Consultation Learning Environment to Optimize Teaching and Learning. Rheum Dis Clin North Am. 2020;46(1):73-83.
  • Rutsky J, Schumacher D, and Mallon D. Relevance, quick hits, and vibe: Features of meaningful teaching and learning during trainee consult interactions. J Hosp Med. 2024;19(1):24-30.
  • Chen DC, Miloslavsky EM, Winn AS, and McSparron JI. Fellow as Clinical Teacher (FACT) Curriculum: Improving Fellows' Teaching Skills During Inpatient Consultation. MedEdPORTAL. 2018;14:10728.
  • Ta K and Gardner GC. Evaluation of the activity of an academic rheumatology consult service over 10 years: using data to shape curriculum. J Rheumatol. 2007;34(3):563-6.
  • Burwick N, Stein J, Garcia DA, Broudy VC, and Richard RE. Monoclonal gammopathies: Electronic subspecialty consultation. Eur J Haematol. 2018;100(4):351-55.
  • Su DG, Rehman S, Wang K, et al. Outcomes Following Implementation of an Electronic Model for Perioperative Hematologic Consultation. J Surg Res. 2024;301:10-17.
  • Dosani T, Xiang J, Wang K, et al. Impact of Hematology Electronic Consultations on Utilization of Referrals and Patient Outcomes in an Integrated Health Care System. JCO Oncol Pract. 2022;18(4):e564-e73.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Hematoloji
Bölüm Araştırma Makalesi
Yazarlar

Ayşe Nilgün Kul 0000-0003-1806-2261

Esra Turan Erkek 0000-0001-7206-6699

Yayımlanma Tarihi 31 Aralık 2024
Gönderilme Tarihi 20 Kasım 2024
Kabul Tarihi 26 Aralık 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 15 Sayı: 4

Kaynak Göster

APA Kul, A. N., & Turan Erkek, E. (2024). A comprehensive retrospective review of ınpatient hematology consultations at a tertiary care hospital. Turkish Journal of Clinics and Laboratory, 15(4), 633-641. https://doi.org/10.18663/tjcl.1588403
AMA Kul AN, Turan Erkek E. A comprehensive retrospective review of ınpatient hematology consultations at a tertiary care hospital. TJCL. Aralık 2024;15(4):633-641. doi:10.18663/tjcl.1588403
Chicago Kul, Ayşe Nilgün, ve Esra Turan Erkek. “A Comprehensive Retrospective Review of ınpatient Hematology Consultations at a Tertiary Care Hospital”. Turkish Journal of Clinics and Laboratory 15, sy. 4 (Aralık 2024): 633-41. https://doi.org/10.18663/tjcl.1588403.
EndNote Kul AN, Turan Erkek E (01 Aralık 2024) A comprehensive retrospective review of ınpatient hematology consultations at a tertiary care hospital. Turkish Journal of Clinics and Laboratory 15 4 633–641.
IEEE A. N. Kul ve E. Turan Erkek, “A comprehensive retrospective review of ınpatient hematology consultations at a tertiary care hospital”, TJCL, c. 15, sy. 4, ss. 633–641, 2024, doi: 10.18663/tjcl.1588403.
ISNAD Kul, Ayşe Nilgün - Turan Erkek, Esra. “A Comprehensive Retrospective Review of ınpatient Hematology Consultations at a Tertiary Care Hospital”. Turkish Journal of Clinics and Laboratory 15/4 (Aralık 2024), 633-641. https://doi.org/10.18663/tjcl.1588403.
JAMA Kul AN, Turan Erkek E. A comprehensive retrospective review of ınpatient hematology consultations at a tertiary care hospital. TJCL. 2024;15:633–641.
MLA Kul, Ayşe Nilgün ve Esra Turan Erkek. “A Comprehensive Retrospective Review of ınpatient Hematology Consultations at a Tertiary Care Hospital”. Turkish Journal of Clinics and Laboratory, c. 15, sy. 4, 2024, ss. 633-41, doi:10.18663/tjcl.1588403.
Vancouver Kul AN, Turan Erkek E. A comprehensive retrospective review of ınpatient hematology consultations at a tertiary care hospital. TJCL. 2024;15(4):633-41.


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