MP85-10 HIGH RATES OF ADMISSION SEEN WITH ADULT SPINA BIFIDA PATIENTS PRESENTING TO THE EMERGENCY ROOM

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction I1 Apr 2017MP85-10 HIGH RATES OF ADMISSION SEEN WITH ADULT SPINA BIFIDA PATIENTS PRESENTING TO THE EMERGENCY ROOM Stephanie Kielb, Richard Matulewicz, and Oluwarotimi Nettey Stephanie KielbStephanie Kielb More articles by this author , Richard MatulewiczRichard Matulewicz More articles by this author , and Oluwarotimi NetteyOluwarotimi Nettey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2672AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The majority of spina bifida patients are now living to adulthood, but finding adult providers to care for these patients is a known transitional challenge. We evaluated the use of the emergency room (ER) by these patients, the presenting complaint, rates of admission, and admitting diagnosis. METHODS A retrospective review of all patients with a diagnosis of spina bifida (SB) and neurogenic bladder presenting to the Northwestern University Hospital ER from 2008-2015 was conducted. Information on chief complaint, admitting diagnosis, admission disposition, and imaging utilization was collected. RESULTS 231 patients were identified that met study criteria. The chief complaint was abdominal pain/nausea/vomiting/diarrhea in 33, headache/shunt issues in 30, skin issues or pressure sores in 25, chills/fevers of unknown origin in 22, urinary tract infection (upper or lower) in 22, back/flank pain in 16 (with known nephrolithiasis in 5), catheter issues in 13, chest pain/cough in 12, post-operative complications in 8, and dialysis complications in 7, with the remainder comprising a variety of complaints. Of the 231 SB patients, 199 (90%) were kept overnight, 179 (77%) for inpatient hospitalization and 13% for overnight observation. The most common admitting diagnoses were urinary tract infection, abdominal pain, cellulitis, and osteomyelitis. Of these 231 patients, 154 (68%) had a urine culture sent regardless of chief complaint. CONCLUSIONS Adult spina bifida patients present to the emergency with varied chief complaints. The overwhelming majority are admitted for in-patient management. The most common chief complaints were abdominal pain, headache/shunt issues, and skin issues/pressure sores. The majority of patients had a urine culture sent despite often non-urologic chief complaints. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1151 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Stephanie Kielb More articles by this author Richard Matulewicz More articles by this author Oluwarotimi Nettey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...