Title :

Impact on patient management of the implementation of a magnetic resonance imaging dedicated to neurological emergencies

Author(s) :

Destee, Marie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Marc, Jean-Baptiste [Auteur]
WIEL, Eric [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Vilhelm, Christian [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Leclerc, Xavier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 [TCDV]
Lenne, Xavier [Auteur]
Hubert, Hervé [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]

Journal title :

Journal of evaluation in clinical practice

Abbreviated title :

J. Eval. Clin. Pract.

Volume number :

23

Pages :

1180-1186

Publication date :

2017-12-01

ISSN :

1356-1294

English keyword(s) :

acute stroke
stroke mimics
MRI
emergency department
brain imaging

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: Neurological emergencies consumed a high amount of resources in emergency department (ED). We aimed to study the effect of the implementation of a magnetic resonance imaging (MRI) dedicated to emergencies on the ...
Show more >OBJECTIVE: Neurological emergencies consumed a high amount of resources in emergency department (ED). We aimed to study the effect of the implementation of a magnetic resonance imaging (MRI) dedicated to emergencies on the management of patients admitted in ED for neurological emergencies. METHODS: We enrolled consecutive patients who underwent computed tomography and/or MRI for neurological disorders categorized as the suspicion of stroke and other reasons, over 2 periods that differed according to the priority access to computed tomography in the first period versus priority access to MRI in the second one. Criteria used to evaluate the effectiveness of the management were door-to-imaging time, ED length of stay, diagnostic performance, patient orientation, and length of hospitalization stay. RESULTS: When priority access to MRI, the door-to-imaging time was 31 minutes longer (P = .005) for patients suspected of stroke or transient ischaemic attack (TIA) and 70 minutes for the others (P < .001). The ED length of stay was 42 minutes shorter (P = .013) for stroke/TIA patients and 26 minutes longer (P = .029) for other patients. The proportion of patients with stroke mimics (no stroke amongst suspected stroke/TIA) increased (16.7% vs 25.6%, P = .017) as well as discharged patients (21.6% vs 29.6%, P = .002). The proportion of patients with stroke/TIA amongst other reasons of admission remained unchanged (P = .114). The median length of hospitalization stay decreased from 9 to 7 days for the stroke/TIA patients (P = .042). CONCLUSIONS: The implementation of a MRI optimized the quality of care and diagnostic accuracy for patients admitted in ED with a better identification of stroke mimics, avoiding unnecessarily hospitalizations. The management of stroke-TIA patients was not modified, but their length of hospital stay reduced.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-11-27T13:33:24Z