scholarly journals What can be expected to be seen in a Neurology ward? Eleven-year experience in a Brazilian university hospital

2021 ◽  
Author(s):  
Daniel Gabay MOREIRA ◽  
Enedina Maria Lobato de OLIVEIRA ◽  
Fernando Morgadinho dos Santos COELHO ◽  
Henrique Ballalai FERRAZ ◽  
Silvio FRANCISCO ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Cerebrovascular Disorders ◽  
Final Diagnosis ◽  
International Classification Of Diseases ◽  
University Hospital ◽  
Lesion Site ◽  
Neurological Patient ◽  
Classification Of Diseases ◽  
Disease Pattern ◽  
The Brain

ABSTRACT Background: Neurological disorders are significant causes of morbidity and mortality worldwide. However, data about general neurological inpatient admissions in Brazil is limited. Objective: To investigate the prevalence of neurological disorders according to disease group and lesion site among patients admitted to a general Neurology ward. Methods: This was an observational and descriptive study. The hospital discharge database for the Neurology ward was surveyed in accordance with the International Classification of Diseases, 10th edition (ICD-10), from September 2008 to October 2019. The final diagnosis was classified into neurological disorder groups and site. Results: Overall, 2,606 clinical neurological patient files were included, with mean length of hospitalization of 16.7 days and a total of 325 readmissions (12.5%). The overall mortality rate in the ward was 3.8% (100 patients). Among all the diagnoses, cerebrovascular disease was the most prevalent (45.8%), followed by inflammatory disorders (22.2%). The brain was the most common lesion site (66.0%), followed by peripheral nerves (10.0%) and meninges and cerebrospinal fluid (7.7%). Conclusions: The disease pattern upon admission showed that a majority of the cases consisted of cerebrovascular disorders and that the brain was the most frequently affected structure, although we observed that a wide variety of cases were admitted, encompassing all neurological disorders.

scholarly journals Predictors of Cerebral Arteriovenous Malformation Mortality: A Single-center, Five-year Retrospective Study

2021 ◽  
Vol 9 (3) ◽  
pp. 213-218
Author(s):  
Patricio Garcia-Espinosa ◽  
Edgar Botello-Hernández ◽  
Gabriela Torres-Hernández ◽  
Clarissa Guerrero-Cavazos ◽  
Estefania Villareal-Garza ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Univariate Analysis ◽  
International Classification Of Diseases ◽  
University Hospital ◽  
P Value ◽  
Predictors Of Mortality ◽  
The Hours ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
History Of

Background: Arteriovenous Malformations (AVMs) are abnormalities in intracranial vessels between the arterial and venous systems. This study aimed to identify the predictors of mortality in patients that presented to our hospital with AVMs, ruptured or unruptured, and correlate them to those available in the literature. Methods: An analytical, observational, retrospective study was performed to review data of patients with cerebral AVMs in the University Hospital “Dr José Eleuterio González” from January 2016 to December 2020. Clinical files were reviewed based on AVMs diagnosis according to the  International Classification of Diseases 10th Revision, ICD-10. Variables were subjected to a univariate analysis and those found significant (p-value < 0.05) were subjected to a logistic regression. Results: A total of 80 patients were included in our study. Most of the participants were females (56.3%) and three were pregnant. The most common presenting symptom was holocranial headache (34 cases) occurring between the hours of 22:00 to 7:00. The most significant predictors of mortality were a total bleeding volume greater than 9.18 cm3 (p = 0.010), the presence of more than one symptom (p = 0.041), and a history of previous cerebral intraparenchymal hemorrhage (p = 0.014). Conclusion: Results demonstrated an important association between intracranial bleeding and mortality. Ultimately, more prospective studies are needed to determine predictor factors for mortality in AVMs patients.

PUBLIC HEALTH, NURSING, AND MEDICAL SOCIAL WORK

PEDIATRICS ◽  
1959 ◽  
Vol 23 (4) ◽  
pp. 761-765
Author(s):  
Myron E. Wegman
Keyword(s):  
Causes Of Death ◽  
Geographic Area ◽  
Final Diagnosis ◽  
International Classification Of Diseases ◽  
Limiting Factor ◽  
Standard Nomenclature ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Health Nursing

Every physician who has been through an internship is familiar with the Standard Nomenclature of Diseases and Operations. Far fewer know the International Statistical Classification of Diseases, Injuries and Causes of Death or appreciate the relationship between the two. Official inauguration of the use of the Seventh Revision of the International Classification of Diseases on January 1, 1958 offers occasion for reviewing some of the considerations affecting the proper naming and classification of diseases and causes of death. It is necessary to clarify the distinction between a "nomenclature" and a "classification." A nomenclature is a list of all terms considered satisfactory in medical usage at the time the nomenclature was prepared. Its primary purpose is to promote use of the same name for the same disease, a necessity for comparability of reports and effective study of a disease. To achieve such uniformity there must be some background of usage and custom, as well as a systematic reference work to help the physician arrive at and use the standard term as a final diagnosis for his case. The Standard Nomenclature of Diseases and Operations of the American Medical Association is in practically universal use in the major institutions of the U. S. A. The Nomenclature itself, while detailed and inevitably complicated by extent of coverage and inclusiveness, follows such a logical pattern that under the pressure of institutional rules and routines it is not difficult to use the system efficiently. Individual physicians, however, are not so disposed to spend the time necessary to follow the Nomenclature and tend rather to use the terminology popular in the geographic area where they are working. Development of local terminologies and usages is perhaps the greatest limiting factor militating against a really general nomenclature.

Ocular emergencies presenting to an emergency department in Central Spain from 2013 to 2018

2019 ◽  
pp. 112067211989642
Author(s):  
Alicia Galindo-Ferreiro ◽  
Hortensia Sanchez-Tocino ◽  
Yago Varela-Conde ◽  
Cecilia Diez-Montero ◽  
Minal Belani-Raju ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
International Classification Of Diseases ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Care Providers ◽  
Primary Health Care Providers ◽  
Ocular Surface Diseases ◽  
Classification Of Diseases

Purpose: To determine the frequency of ocular conditions among patients presenting to an emergency department at a tertiary hospital in Spain. Methods: A retrospective, longitudinal analysis of all patients who presented to the ocular emergency department of Rio Hortega University Hospital, Valladolid, Spain, from 2013 to 2018 was performed. Data on demographics, ophthalmic examination, and diagnosis were collected. Diseases were classified according the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Results: We had 20,822 patients, of which 10,878 (52.2%) were women. The main age categories were 45–65 years (7391 patients; 35.5%) and 15–45 years (5979 patients; 28.2%). Most of the patients (17,793; 85.5%) were discharged on the same day. Conjunctival pathology was the most common cause of presentation (4110; 19.7%), followed by corneal disorders (4025; 19.3%). Acute conjunctivitis was diagnosed in 2920 (14%) and ocular trauma in 2125 (10.2%) patients. Non-emergency ophthalmic conditions were diagnosed in 1581 (7.6%) patients. Retinal detachments and peripheral holes occurred more commonly in patients aged 45–65 years ( p <0.001). Corneal or conjunctival disorders and lid inflammation ( p <0.001) were more frequent in women, whereas men had higher incidences of trauma ( p <0.001). Conclusion: Most of our patients presented ocular surface diseases. Men were more vulnerable to trauma, mainly superficial foreign body. The majority of the patients presented with uncomplicated ocular conditions that would be managed more cost-effectively by primary health care providers. We advocate greater education of primary care physicians and patients in managing simple ocular emergencies to reduce the cases presenting to an emergency department of a tertiary hospital.

scholarly journals Shoulder Capsular Surgery in Finland Between 1999 and 2008: A Nationwide Register Analysis

2018 ◽  
Vol 107 (2) ◽  
pp. 172-179 ◽  
Author(s):  
L. Kavaja ◽  
A. Malmivaara ◽  
T. Lähdeoja ◽  
V. Remes ◽  
R. Sund ◽  
...  
Keyword(s):  
Scientific Evidence ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
University Hospital ◽  
National Hospital Discharge Register ◽  
Total Incidence ◽  
Classification Of Diseases ◽  
Register Analysis ◽  
Almost All ◽  
Arthroscopic Procedures

Background and Aims: Shoulder capsular surgery is nowadays usually performed arthroscopically, and the proportion of arthroscopic method has rapidly increased during the last two decades. We assessed the incidence of shoulder capsular surgery procedures in Finland between 1999 and 2008. Material and Methods: We gathered the shoulder capsular surgery procedures for all kinds of shoulder instability in Finland between 1999 and 2008 from National Hospital Discharge Register and limited the patient material to include only certain diagnosis (International Classification of Diseases, 10th Edition) and Nordic Medico-Statistical Committee procedure code combinations. We analyzed the data in the whole country, between different age groups, and in university hospital districts. Results: The total incidence of shoulder capsular surgery procedures in Finland increased from 17 to 33 per 100,000 person-years. The incidence of arthroscopic procedures increased from 11 to 30 per 100,000 person-years and the proportion of arthroscopic procedures increased from 63% to 92% between years 1999 and 2007. The incidence of shoulder capsular surgery procedures increased on average around 90% in almost all age groups and particularly in the older age groups. We observed no significant geographical variation between university hospital districts. Conclusion: The incidence of shoulder capsular surgery procedures increased on average round 90% in almost all age groups. It seems to be difficult to support the rapidly increased rates of shoulder capsular surgery procedures or the arthroscopic method based on scientific evidence. While also older patients are treated with shoulder capsular surgery, well-defined indications for surgical intervention are needed so that the operations are conducted for the symptomatic patients benefitting most regardless of patients’ age.

scholarly journals Trigger Team Activation for Acute Patients. A Cohort Study at a Level 1 University Hospital in Denmark

2020 ◽  
Author(s):  
Stefan Posth ◽  
Lonnie Froberg ◽  
Søren Bak ◽  
Lisette Okkels Jensen ◽  
Mikkel Brabrand ◽  
...  
Keyword(s):  
Cohort Study ◽  
Local Area ◽  
International Classification Of Diseases ◽  
Trauma Centre ◽  
University Hospital ◽  
Medical Emergency ◽  
Catheterization Laboratory ◽  
Day Range ◽  
Classification Of Diseases ◽  
Level 1

Abstract Background: While patients with major trauma, suspected ST-elevation myocardial infarction (STEMI) or stroke have implemented pathways for quick access to specialized trigger teams, other patients with time dependent diseases present with less obvious aetiology and have less documented pathways at arrival to the hospital. Aim: To describe the number, diagnosis and prognosis of patients arriving to the trigger teams for trauma, suspected STEMI, suspected stroke, and Medical emergency patients (MEP) Method: Retrospective cohort study of all patients who between November 2012 and September 2015 had either a trauma, STEMI, stroke or MEP trigger team activation at arrival to Odense University Hospital – a level 1 trauma centre, a direct referral centre for patients with suspected STEMI to the catheterization laboratory or stroke, and with a trigger team at emergency department arrival of MEP patients from the local area. Results: There were 8,075 activations of a trigger team at hospital arrival, median 7.6 calls per day (range 1-18); 16.7% trauma, 28.3% STEMI, 19.7% stroke and 35.3% MEP calls. This corresponds to 161/100,000 person years (py) with trauma calls, 64/100,000 py STEMI calls, 72/100,000 py stroke calls and 340/100,000 py MEP calls. Patients from the different calls had a 30-day mortality of 12% (trauma), 8% (STEMI), 5% (stroke), and 25% (MEP). Whereas patients from trauma, STEMI and stroke calls were mainly discharged within a few ICD10 (International classification of diseases, version 10) main coding areas, patients from MEP calls had discharge diagnosis within many different ICD10 main coding areas. Conclusion: Trauma, STEMI and stroke trigger teams are used at a daily base, treat a prehospitally well-defined patient population and have a relatively low 7-day mortality. Patients with MEP calls are more frequent, have a diverse aetiology and a higher mortality than patients in the other trigger teams.

scholarly journals Can AI Help Pediatricians? Diagnosing Kawasaki Disease Using DRSA

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 929
Author(s):  
Bartosz Siewert ◽  
Jerzy Błaszczyński ◽  
Ewelina Gowin ◽  
Roman Słowiński ◽  
Jacek Wysocki
Keyword(s):  
Kawasaki Disease ◽  
General Condition ◽  
Early Stage ◽  
Laboratory Data ◽  
Decision Rules ◽  
Final Diagnosis ◽  
International Classification Of Diseases ◽  
Reactive Protein ◽  
Classification Of Diseases ◽  
Icd 10

The DRSA method (dominance-based rough set approach) was used to create decision-making rules based on the results of physical examination and additional laboratory tests in the differential diagnosis of Kawasaki disease (KD), infectious mononucleosis and S. pyogenes pharyngitis in children. The study was conducted retrospectively. The search was based on the ICD-10 (International Classification of Diseases) codes of final diagnosis. Demographic and laboratory data from one Polish hospital (Poznan) were collected. Traditional statistical methods and the DRSA method were applied in data analysis. The algorithm formed 45 decision rules recognizing KD. The rules with the highest sensitivity (number of false negatives equals zero) were based on the presence of conjunctivitis and CRP (C-reactive Protein) ≥ 40.1 mg/L, thrombocytosis and ESR (Erythrocyte Sedimentation Rate) ≥ 77 mm/h; fair general condition and fever ≥ 5 days and rash; fair general condition and fever ≥ 5 days and conjunctivitis; fever ≥ 5 days and rash and CRP ≥ 7.05 mg/L. The DRSA analysis may be helpful in diagnosing KD at an early stage of the disease. It can be used even with a small amount of clinical or laboratory data.

scholarly journals Comparison of the mortality rate due to neurological diseases in Brazil: an epidemiological study from the last 5 years

2021 ◽  
Author(s):  
Diego Paixão Côrtes Aguiar ◽  
Daniela Witz Aquino ◽  
Elisa Kalil Vinholes
Keyword(s):  
Mortality Rate ◽  
Epidemiological Study ◽  
Neurological Disorders ◽  
Professional Training ◽  
Neurological Diseases ◽  
International Classification Of Diseases ◽  
National Average ◽  
Unified Health System ◽  
Classification Of Diseases

Background: In Brazil, about 9 thousand people die annually from nervous system (NS) diseases and its complications. Additionally, the neuropathology mortality rate (MR) is in eighth place, when considering the 21 chapters of the International Classification of Diseases. Objectives: To analyze the MRs of neurological disorders in the 5 regions of Brazil and to identify where professional training or increased investment may be necessary. Methods: Epidemiological study, whose statistics were taken from the Department of Informatics of the Brazilian Unified Health System (DATASUS). Results: The following MRs due to diseases of the NS were found for each region, in decreasing order: North (6.21%); Southeast (4.98%); Northeast (4.77%); South (3.96%); Midwest (3.93%). Also, the national average is expressed by a rate of 4.68%. It was also possible to observe that states in the same region have similar MRs, with some exceptions. Furthermore, the states with the highest MRs are Amazonas (9.42%); Acre (8.94%) and Rio de Janeiro (7.58%). Also, it was possible to notice that the states with the highest mortality, were those that invested less in patients with neurological disorders. However, the monetary factor is not the only determining aspect, since in some places that have similar investments, it is possible to identify a high difference between the MRs. Conclusions: Therefore, Brazil presents differences between the MRs due to diseases of the NS according to each region. It is evident that investments are fundamental, since states that invest less are, for the most part, those with the highest MRs.

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