Dermatology consultation service at a large metropolitan hospital system serving minority populations

Autor: Suchismita Paul, Sonali Nanda, Brandon Burroway, V. De Bedout, S. Stratman, Rachel Fayne, Andrea D. Maderal, N. Sanchez, Jordan D. Rosen, George W. Elgart, Evan Darwin, Nicole Nagrani, Robert S. Kirsner, David E. Castillo, Adrianna Gonzalez, Anna J. Nichols
Rok vydání: 2020
Předmět:
Zdroj: Journal of the European Academy of Dermatology and Venereology. 34:2120-2126
ISSN: 1468-3083
0926-9959
DOI: 10.1111/jdv.16565
Popis: BACKGROUND Dermatology consultations in the inpatient hospital setting can improve diagnostic accuracy and management. OBJECTIVE Characterize dermatologic diagnostic and treatment trends in the hospital setting and identify variables that may affect patient care. METHODS Retrospective chart review from 1 January 2012 to 31 December 2017 at Jackson Memorial Hospital (JMH) (Miami, Florida, USA), an academic non-profit tertiary care centre affiliated with University of Miami Miller School of Medicine, was performed. Patients who received dermatology consultations in the emergency department (ED) or inpatient settings were included. Patient demographics, admission information, provisional diagnosis and management plans by primary teams, final diagnosis, management plans and testing recommendations by the dermatology consults team, and follow-up information were collected. Analysis using Microsoft Excel of how time to consultation, admission length, inpatient versus ED setting and primary team affected diagnostic accuracy was also performed. RESULTS The 1004 consultations for 812 patients (n = 812) were reviewed (359 women, 453 men). Most patients were Hispanic (n = 359; 44.2%) or African American (n = 273; 33.6%). Mean admission length was 20.6 days (range 0-439; median 6). The most common consulting service was internal medicine (n = 452). In 387 cases (47.6%), primary teams did not give a provisional diagnosis. The most common provisional diagnoses were bacterial infection (n = 93), viral infection (n = 49) and drug reaction (n = 44). The most common diagnoses by dermatology were viral infection (n = 93), bacterial infection (n = 90) and drug reaction (n = 80). Dermatology consultation changed the provisional diagnosis in 55.7% of cases, more often in cases where consultation took place ≥2 days after admission (P
Databáze: OpenAIRE
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