Management of patients in a combined thyroid eye clinic in secondary care
Autor: | T. Kersey, Bijay Vaidya, D. McGrane, Lynne Goss, James D. Benzimra, Anthony G. Quinn |
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Rok vydání: | 2013 |
Předmět: |
Adult
Male Clinical audit Pediatrics medicine.medical_specialty Adolescent Eye disease Secondary care Young Adult Surveys and Questionnaires Outcome Assessment Health Care Health care medicine Humans Euthyroid Prospective Studies Young adult Prospective cohort study Secondary Care Centers Aged Aged 80 and over Clinical Audit Delivery of Health Care Integrated business.industry Thyroid Middle Aged medicine.disease Graves Disease United Kingdom Graves Ophthalmopathy Ophthalmology medicine.anatomical_structure Physical therapy Female business |
Zdroj: | International Ophthalmology. 34:1-6 |
ISSN: | 1573-2630 0165-5701 |
Popis: | The European Group on Graves' Orbitopathy (EUGOGO) recommends the use of specialised multidisciplinary clinics for the management of thyroid eye disease (TED). In the UK, many patients with TED are managed outside of specialised clinics. We describe the organisation of a combined TED clinic in a secondary care setting and present the result of a prospective audit of the patient characteristics and outcomes during the first four years of a combined TED clinic. Of a total of 132 patients referred to the TED clinic, 114 (86 %) had TED (90 females, median age 56 years; range 17-90 years). At presentation, 77 (67 %) were current or ex-smokers and 99 (87 %) were biochemically euthyroid. Median duration of eye symptoms was 12 months. Fifty-two percent, 45 and 3 had mild, moderate-to-severe and sight-threatening TED, respectively. Only 18 % of patients had a clinical activity score (CAS) of ≥3. Sixty-nine patients (61 %) required follow-up appointments in the TED clinic. In those who required follow-up, 43 % (n = 30) received either immunosuppressive or surgical treatment. CAS improved from first to final visit, with 29 % (n = 20) having a CAS of ≥3 at the first visit and 1 % (n = 1) at the final visit (p = 0.0001). There was also a decrease in prevalence of smoking and thyroid dysfunction at the final visit. A multidisciplinary specialised TED clinic offers an optimal setting for managing patients with TED; however, patients are often referred late to a specialist TED clinic. |
Databáze: | OpenAIRE |
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