930 Cauda Equina Syndrome Referrals: A Single Centre Experience

Abstract

Abstract Aim Cauda Equina Syndrome (CES)is a neurosurgical emergency that requires prompt surgical intervention. History and examination performed by referring departments play an imperative role in the triaging of these patients for onward radiological investigation. We aimed to compare radiologically confirmed cauda equina syndrome to the CES referrals to our tertiary unit to elucidate the true regional incidence of CES. Method All CES referrals over a 4 year period (2018–2021) made using the electronic patient referral portal, referapatient.orgtm, were collated. The incidence of radiological confirmed CES was identified. Results 2018: 231 CES referrals of which 26 were radiological CES and accepted (14 female and 12 male). 2019: 151 referrals of which 20 were radiological CES and accepted (14 female and 6 male). 2020: 257 referrals of which 28 were radiological CES accepted (16 female and 12 male). 2021 (first 6 months): 89 referrals of which 16 were radiological CES and accepted (7 female and 9 male). Conclusions In 2018–2021 we received 728 CES referrals of which 90 were radiologically CES and required surgical management. There were 51 female and 39 male patients. 211 referrals were from our own Hospital (Hub) while 517 referrals were from 6 other (Spoke) Hospitals. 12.36% had radiological CES. This represents just over 1 in 10 referrals from secondary care facilities. A greater understanding of the condition via the utilisation of large electronic datasets may facilitate the formulation of novel scoring systems to more accurately appraise cases of putative CES to avoid unnecessary transfers to tertiary centres.