Two-year analysis of dermatological out-of-hours consultations at Frankfurt University Hospital.

Abstract

In recent years, emergency consultations have become more common in all medical disciplines. In Germany, dermatological out-of-hours consultations are handled by emergency practices, emergency departments and tertiary care providers. Little information is available on the reasons for these dermatological consultations. The aim of this study was to analyze patient characteristics, diagnoses and admission rates resulting from these consultations. We conducted a retrospective study covering two years of out-of-hours consultations at a dermatological tertiary referral center. A total of 3635 patients presented at the referral center. The most frequent outpatient diagnoses were acute urticaria (13.8%) and bacterial infections (12.3%). 83% of the outpatient diagnoses required the most advanced competence level according to the new German curriculum for undergraduate education of medical students. 405 (11.01%) patients did not require dermatological treatment, and 430 patients (13.6%) were admitted to hospital. Most admissions were due to bacterial infections and herpes zoster. Advanced age, pain and fever were associated with a relatively high risk of admission. Admission rates at the dermatological tertiary referral center were substantially lower than at interdisciplinary emergency departments. A few diagnoses accounted for more than half of all consultations. These diagnoses are well represented within the new German curriculum.