Investigation and diagnostic formulation in patients admitted with transient loss of consciousness.

Investigation and diagnostic formulation in patients admitted with transient loss of consciousness. Ir Med J. 2017 May 10;110(5):563 Authors: Briggs R, Coughlan T, Doherty J, Collins DR, O'Neill D, Kennelly SP Abstract 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. PMID: 28737304 [PubMed - in process]
Source: Ir Med J - Category: General Medicine Authors: Tags: Ir Med J Source Type: research