More than 8% of ED visits from 2016 to 2019 were for neurological complaints
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An estimated 55.8 million patients presented to U.S. emergency departments from 2016 to 2019 with a neurological complaint as the primary reason for their visit, researchers reported in JAMA Neurology.
“Patients with neurological symptoms can be challenging to diagnose and treat in the emergency setting, but population-level data on the number and characteristics of patients who present to U.S. emergency departments with neurological symptoms is scarce,” Ava L. Liberman, MD, of the department of neurology at University of Chicago Medicine, and colleagues wrote.
Researchers analyzed data from the National Hospital Ambulatory Medical Care Survey — a cross-sectional and a nationally representative sample of 361 to 378 EDs of nonfederal hospitals, which make up approximately 10% of U.S. EDs — from 2016 to 2019.
They identified all adult patients with a neurological complaint listed as their first reason for the ED visit and applied survey visit weights to determine national estimates.
From 7,264 sampled cases, researchers estimated 55.8 million (95% CI, 52.7-59.1) patients presented to an ED with a neurological complaint as their main reason for the visit. Of all ED visits, 8.4% (95% CI, 8-8.9) were for neurological complaints, the most common of which were nonspecific and included headache, vertigo, dizziness and general weakness.
Among patients presenting with neurologic complaints, 60% were women, 40% were aged younger than 45 years, and 63% were non-Hispanic white individuals. In addition, they were older (mean age, 51.6 years vs. 47.3 years) and more often women (60.2% vs. 56.8%) compared with all other patients in the ED.
Further, a serious neurological condition was suspected in 10.1% of patients (95% CI, 8.9-11.3), with stroke being the most frequently suspected condition. Nearly 73% of patients with a neurological complaint were discharged.
“Patients with a neurological symptom as their most important presenting complaint account for a high number of ED encounters nationally,” Liberman and colleagues wrote. “Nonspecific neurological symptoms were much more frequently reported than focal weakness, speech issues and vision changes.”