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Neurological Emergencies in Refugees
Objective: Health care personnel in Europe is increasingly involved in care of displaced persons from non-European countries; we investigated the spectrum of neurological disorders and medical management in refugees presenting to the emergency room (ER) of a German university hospital. Methods: We r...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298418/ https://www.ncbi.nlm.nih.gov/pubmed/30643500 http://dx.doi.org/10.3389/fneur.2018.01088 |
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author | Brinckmann, Marie P. van Noort, Betteke M. Leithner, Christoph Ploner, Christoph J. |
author_facet | Brinckmann, Marie P. van Noort, Betteke M. Leithner, Christoph Ploner, Christoph J. |
author_sort | Brinckmann, Marie P. |
collection | PubMed |
description | Objective: Health care personnel in Europe is increasingly involved in care of displaced persons from non-European countries; we investigated the spectrum of neurological disorders and medical management in refugees presenting to the emergency room (ER) of a German university hospital. Methods: We retrospectively studied ER-patients with refugee status (R-patients) during the peak of the European refugee crisis between July 2015 and February 2016 (N = 100). Complaints on admission, medical management and diagnoses at discharge were compared to matched groups of German residents with migrational background (M-patients; N = 96) and to native Germans (N-patients; N = 95). Results: R-patients were mostly male young adults (75% male; mean age 33.2 years). Headache was the most frequent complaint in all groups (R-patients 38%; M-patients 43%; N-patients 24%). R-patients, however, presented much more often with possible or definite seizures (R-patients 27%; M-patients 9%; N-patients 15%). Initial triage, length of medical history and examination records, utilization of laboratory tests and cranial imaging did not differ between groups. However, time to diagnosis was considerably longer in R-patients (220 min; M-patients 151 min, N-patients 123 min). While strokes and other life-threatening emergencies were rare final diagnoses in R-patients, a substantial proportion was discharged with a diagnosis of non-epileptic seizures or a psychiatric disorder (20%; M-patients 6%; N-patients 7%). Conclusions: Refugee patients present with a spectrum of neurological disorders that not solely results from cultural differences but rather reflects the consequences of forced displacement. ER management of refugees requires more time, language skills and critically depends on psychosomatic/psychiatric expertise. |
format | Online Article Text |
id | pubmed-6298418 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62984182019-01-14 Neurological Emergencies in Refugees Brinckmann, Marie P. van Noort, Betteke M. Leithner, Christoph Ploner, Christoph J. Front Neurol Neurology Objective: Health care personnel in Europe is increasingly involved in care of displaced persons from non-European countries; we investigated the spectrum of neurological disorders and medical management in refugees presenting to the emergency room (ER) of a German university hospital. Methods: We retrospectively studied ER-patients with refugee status (R-patients) during the peak of the European refugee crisis between July 2015 and February 2016 (N = 100). Complaints on admission, medical management and diagnoses at discharge were compared to matched groups of German residents with migrational background (M-patients; N = 96) and to native Germans (N-patients; N = 95). Results: R-patients were mostly male young adults (75% male; mean age 33.2 years). Headache was the most frequent complaint in all groups (R-patients 38%; M-patients 43%; N-patients 24%). R-patients, however, presented much more often with possible or definite seizures (R-patients 27%; M-patients 9%; N-patients 15%). Initial triage, length of medical history and examination records, utilization of laboratory tests and cranial imaging did not differ between groups. However, time to diagnosis was considerably longer in R-patients (220 min; M-patients 151 min, N-patients 123 min). While strokes and other life-threatening emergencies were rare final diagnoses in R-patients, a substantial proportion was discharged with a diagnosis of non-epileptic seizures or a psychiatric disorder (20%; M-patients 6%; N-patients 7%). Conclusions: Refugee patients present with a spectrum of neurological disorders that not solely results from cultural differences but rather reflects the consequences of forced displacement. ER management of refugees requires more time, language skills and critically depends on psychosomatic/psychiatric expertise. Frontiers Media S.A. 2018-12-11 /pmc/articles/PMC6298418/ /pubmed/30643500 http://dx.doi.org/10.3389/fneur.2018.01088 Text en Copyright © 2018 Brinckmann, van Noort, Leithner and Ploner. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Brinckmann, Marie P. van Noort, Betteke M. Leithner, Christoph Ploner, Christoph J. Neurological Emergencies in Refugees |
title | Neurological Emergencies in Refugees |
title_full | Neurological Emergencies in Refugees |
title_fullStr | Neurological Emergencies in Refugees |
title_full_unstemmed | Neurological Emergencies in Refugees |
title_short | Neurological Emergencies in Refugees |
title_sort | neurological emergencies in refugees |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298418/ https://www.ncbi.nlm.nih.gov/pubmed/30643500 http://dx.doi.org/10.3389/fneur.2018.01088 |
work_keys_str_mv | AT brinckmannmariep neurologicalemergenciesinrefugees AT vannoortbettekem neurologicalemergenciesinrefugees AT leithnerchristoph neurologicalemergenciesinrefugees AT plonerchristophj neurologicalemergenciesinrefugees |