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Investigation and diagnostic formulation in patients admitted with transient loss of consciousness
Briggs, R; Coughlan, T; Doherty, J; Collins, DR; O’Neill, D; Kennelly, SP
Several commonly completed tests have low diagnostic yield in the setting of transient loss of consciousness (T-LOC). We estimated the use and cost of inappropriate investigations in patients admitted with T-LOC and assessed if these patients were given a definitive diagnosis for their presentation. We identified 80 consecutive patients admitted with T-LOC to a university teaching hospital. Eighty-eight percent (70/80) had a computerized topography (CT) brain scan and 49% (34/70) of these scans were inappropriate based on standard guidelines. Almost half (17/80) of electroencephalograms (EEG) and 82% (9/11) of carotid doppler ultrasound performed were not based on clinical evidence of seizure or stroke respectively. Forty-four percent (35/80) of patients had no formal diagnosis documented for their presentation. Inappropriate investigation in T-LOC is very prevalent in the acute hospital, increasing cost of patient care. In addition, there is poor diagnostic formulation for T-LOC making recurrent events more likely in the absence of definitive diagnoses
Keyword(s): DIAGNOSIS; NEUROLOGICAL DISEASES AND DISORDERS; STROKE AND TIA
Publication Date:
2017
Type: Journal article
Peer-Reviewed: Unknown
Language(s): English
Institution: Lenus
Publisher(s): Irish Medical Journal
First Indexed: 2017-05-18 09:48:05 Last Updated: 2018-03-13 06:52:45