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

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    Authors
    Briggs, R
    Coughlan, T
    Doherty, J
    Collins, DR
    O’Neill, D
    Kennelly, SP
    Issue Date
    2017-05
    Keywords
    DIAGNOSIS
    NEUROLOGICAL DISEASES AND DISORDERS
    STROKE AND TIA
    
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    Publisher
    Irish Medical Journal
    Journal
    Irish Medical Journal
    URI
    http://hdl.handle.net/10147/621370
    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
    Item Type
    Article
    Language
    en
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    Tallaght University Hospital

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