title: Pattern of in-patient neurologic review: An experience from a Tertiary Hospital North-Western Nigeria.
abstract: BACKGROUND
  Increase in neurologic diseases burden has increased the demand for neurology services globally, despite the shortcomings of shortage and maldistribution of neurologists worldwide, including Sub-Saharan Africa. This has placed significant pressure on the few available neurologists to provide optimal and effective services in our resource-challenged settings.
  
  
  METHODS
  Neurology referrals were prospectively reviewed over a period of 3 months. Sociodemographic characteristics of the patients, the initial diagnosis by the requesting team, the reasons for the consult/referral, the requesting personnel, duration of hospital stay before request, the time interval between receiving the request and review, the working and final diagnosis after the review, and the diagnostic outcome of neurologic review were analyzed using Predictive Analytics Software® version 18.0.0 for Windows (Chicago, Illinois, USA).
  
  
  RESULTS
  Fifty-three hand written in-patient requests were reviewed over the period of study given an average rate of 4.4/week. The mean age was 50.8 ± 16.1 years, and the median length of stay before a review was 1 day (interquartile range: 1-2.5 days). Diagnostic outcome of the reviews were; new diagnoses in 4 (11.3%), the incorrect diagnosis changed in 8 (15.1%), contribution to the differential diagnosis in 15 (28.3%), and contribution to management plans in 24 (45.3%) patients. The association between diagnostic outcomes and mortality in our study was not statistically significant (χ2 = 6.66, P = 0.08).
  
  
  CONCLUSIONS
  Our study showed that in-patient neurologic reviews led to significant improvement in diagnostic and management plans. Appropriate policy guidelines should focus more on efficient ways of maximizing benefits of these reviews to patients without overburdening the few available neurologists in our environment.
authors.affiliation: Department of Medicine, Neurology Unit, Aminu Kano Teaching Hospital, Bayero University Kano, Kano, Nigeria.
authors.forename: Aliyu
authors.initials: A
authors.lastname: Ibrahim
authors.forename: Lukman Femi
authors.initials: LF
authors.lastname: Owolabi
authors.forename: Baba Maiyaki
authors.initials: BM
authors.lastname: Musa
authors.forename: Salisu
authors.initials: S
authors.lastname: Aliyu
authors.forename: Musbahu
authors.initials: M
authors.lastname: Rabiu
authors.forename: Ahmed Maifada
authors.initials: AM
authors.lastname: Yakasai
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis*; D009549:Nigeria; D010043:Outcome and Process Assessment, Health Care; D012017:Referral and Consultation; D062606:Tertiary Care Centers; D013997:Time Factors