Clinical utility of electrodiagnostic studies in the inpatient setting.
Although nerve conduction studies/electromyograms are often requested to evaluate hospitalized patients (inpatients) with suspected neuromuscular diseases, their clinical utility has not been studied. They can be technically challenging, especially in intensive care units. We studied the contribution of inpatient electromyograms (IP-EMGs) to the management of patients with suspected neuromuscular disorders. A total of 103 IP-EMGs in 98 patients were analyzed. IP-EMGs confirmed the clinical diagnosis in 53.3% and provided a new, clinically relevant diagnosis in 12.6%. IP-EMGs revealed only an incidental diagnosis in 14.5%, were inconclusive in 16.5%, and were normal in 3%. In over a quarter of patients, IP-EMGs assisted in planning further diagnostic evaluation or treatment. Although IP-EMGs most often only confirm already suspected diagnoses, in a substantial minority of patients they lead to the identification of clinically unsuspected, significant diagnoses that alter subsequent clinical care. Muscle Nerve 40: 195-199, 2009.
Perry
Daryl I
DI
Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, TCC-8, 330 Brookline Avenue, Boston, Massachusetts 02215, USA.
Tarulli
Andrew W
AW
Nardin
Rachel A
RA
Rutkove
Seward B
SB
Gautam
Shiva
S
Narayanaswami
Pushpa
P
D000200:Action Potentials / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004568:Electrodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009468:Neuromuscular Diseases / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult