Background Admissions to the rheumatology service play an important role in rheumatology training. In the present economic climate where rheumatology patients are often managed as outpatients, these admissions provide a unique opportunity for the trainees to deal with acute and often complicated problems which they may not encounter in the outpatients.
Objectives We reviewed the rheumatology admissions at a teaching hospital over the period of 12 months from January 2011 to December 2011. These were managed by two trainees with the support of 8 consultants.
Methods Retrospective analysis of electronic discharge summaries of all rheumatology admissions over one year period was done with regard to type of admission, reason for the admission, final rheumatologic diagnosis, duration of stay and the different management outcomes.
Results A total of 157 patients were seen by the trainees with the continued support from the consultants. The final diagnosis could be grouped into the following categories: inflammatory arthritis (44.59% 70/157), connective tissue diseases (28.66% 45/157), degenerative/soft tissue (8.28% 13/157), vasculitis (5.09% 08/157), metabolic bone diseases (3.18% 5/157) and infections (1.92%, 3/157)
A separate category named as others (8.28% 13/157) was included. This was a heterogeneous group with diagnoses such as PMR, lymphadenopathy for evaluation, statin induced myositis and stickler syndrome.
Majority of the admissions were elective admissions (60.5%, 95/157) and the rest (39.5%, 62/157) were emergency admissions.
In 33.12% (52/157) of admissions, patients presented with a new symptom and in 66.88% (105/157) of admissions, patients presented with complications or exacerbation of existing rheumatologic problems.
The management outcomes were as follows: steroids started in 32.2% (51/157), disease modifying drugs started in 19.1% (30/157), joints injected in 19.1% (30/157), disease modifying drugs stopped in 5.73% (9/157) and biologics started in 2.54% (4/157). Some of them have had a combination of the above treatments.
Duration of stay in most of these patients was three to four days.
Conclusions This study highlights the range of conditions that were dealt with by the rheumatology trainees over a period of 12 months. The trainees found this exposure to admitted patients extremely valuable for their training and experience.
Disclosure of Interest None Declared
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