title: Workload of on-call emergency room neurologists in a Spanish tertiary care centre. A one-year prospective study.
abstract: BACKGROUND
  Population ageing, the rising demand for healthcare, and the establishment of acute stroke treatment programs have given rise to increases in the number and complexity of neurological emergency cases. Nevertheless, many centres in Spain still lack on-call emergency neurologists.
  
  
  METHODS
  We conducted a retrospective study to describe the role of on-call neurologists at Hospital General Universitario Gregorio Marañón, a tertiary care centre in Madrid, Spain. Sociodemographic characteristics, most common pathologies, diagnostic tests, and destination of the patients attended were recorded daily using a computer database. Results were compared with the general care data from the emergency department.
  
  
  RESULTS
  The team attended 3234 patients (3.48% of the emergency department total). The mean number of patients seen per day was 11.15. The most frequent pathologies were stroke (34%), epilepsy (16%) and headache (8%). The mean stay in the emergency department was 7.17 hours. Hospital admission rate was 40% (7.38% of emergency hospital admissions). The main destinations for admitted patients were the stroke unit (39.5%) and the neurology department (33%). Endovascular or thrombolytic therapies were performed on 76 occasions. Doctors attended 70% of the patients during on-call hours.
  
  
  CONCLUSIONS
  Emergency neurological care is varied, complex, and frequently necessary. Neurological cases account for a sizeable percentage of both patient visits to the emergency room and the total number of emergency admissions. The current data confirm that on-call neurologists available on a 24-hour basis are needed in emergency departments.
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: rodriguezcruzpm@gmail.com.
authors: P M
authors: PM
authors: Rodríguez Cruz
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: J R
authors: JR
authors: Pérez Sánchez
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: J P
authors: JP
authors: Cuello
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: P
authors: P
authors: Sobrino García
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: G
authors: G
authors: Vicente Peracho
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: A
authors: A
authors: García Arratibel
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: D
authors: D
authors: Sánchez Guzmán
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: N
authors: N
authors: Bravo Quelle
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: B
authors: B
authors: Gutiérrez Ruano
authors: Servicio de Neurologia, Hospital La Zarzuela, Madrid, España.
authors: C
authors: C
authors: Alarcón Morcillo
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: F
authors: F
authors: Cordido Henríquez
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: F
authors: F
authors: Romero Delgado
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: A
authors: A
authors: Muñoz González
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: R
authors: R
authors: Domínguez Rubio
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: A M
authors: AM
authors: Iglesias Mohedano
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: M L
authors: ML
authors: Martín Barriga
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: B
authors: B
authors: de la Casa Fages
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España; Unidad de Ictus, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: F
authors: F
authors: Díaz Otero
authors: Servicio de Neurología, Hospital Universitario Quirón, Madrid, España.
authors: D
authors: D
authors: Ezpeleta
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España; Unidad de Ictus, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: A
authors: A
authors: García Pastor
authors: Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España; Unidad de Ictus, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: A
authors: A
authors: Gil Núñez
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D009462:Neurology; D010820:Physicians / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013030:Spain; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data*
keywords: Admissions and discharges; Altas hospitalarias; Emergency department; Emergency neurology; España; Ingresos urgentes; Labor asistencial; Neurology on-call; Neurólogo de guardia; Organisation models; Spain; Urgencias neurológicas; Workload