Presentation Authors: Oluwarotimi Nettey*, Beverly Onyekwuluje, Alicia Roston, Stephanie Kielb, Chicago, IL
Introduction: The majority of spina bifida (SB) patients are now living to adulthood, however finding adult providers to care for these patients is a known transitional challenge. We evaluated the use of the emergency room (ER) by these patients, the presenting complaint, rates of admission, and diagnosis.
Methods: A retrospective review of all patients with a diagnosis of spina bifida and neurogenic bladder presenting to the Northwestern University Hospital ER from 2008-2015 was conducted. Information on chief complaint, admission disposition, imaging utilization and admission diagnosis were collected.
Results: 231 patients were identified that met study criteria. The chief complaint was abdominal pain/nausea/vomiting/diarrhea in 33 (14.3%), headache/shunt issues in 30 (13.0%), skin issues or pressure sores in 25 (10.8%), chills/fevers of unknown origin in 22 (9.5%), urinary tract infection (upper or lower) in 22 (9.5%), back/flank pain in 16 (5 with known nephrolithiasis), catheter issues in 13 (5.6%), chest pain/cough in 12 (5.2%), post-operative complications in 8 (3.5%), and dialysis complications in 7 (3.0%), with the remainder comprising a variety of complaints. Of 231 SB patients, 199 (90%) were kept overnight, 179 (77%) for inpatient hospitalization and 13% for overnight observation. The most common admitting diagnoses were urinary tract infection, abdominal pain, cellulitis, and osteomyelitis. Of these 231 patients, 154 (68%) had a urine culture sent regardless of chief complaint.
Conclusions: Adult SB patients present to the emergency with varied chief complaints. The overwhelming majority are admitted for inpatient management. The most common chief complaints were abdominal pain, headache/shunt issues, and skin issues/pressure sores. The majority of patients had a urine culture sent despite frequent non-urologic chief complaints.
Source of Funding: Supported by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422.