General Characteristics of Rheumatology Consultations in the Emergency Department: Retrospective Results of a Tertiary Hospital

Background: This study aimed to analyze the age, gender, comorbidities, diagnosis of rheumatic diseases, symptoms at presentation, consultation diagnoses, additional consultations and hospitalization rates of adult patients who received a rheumatology consultation from the emergency department (ED) of a tertiary hospital. Methods: We evaluated adult ED patients referred for rheumatology consultation from 2019 to 2022. Coronavirus disease consultations and repeated consultations were excluded. The demographic information of the patients, complaints regarding their presentation to the ED, known inflammatory rheumatological diseases (IRD), comorbidities, departments where consultation was requested, consultation final diagnoses, the clinic to which they were referred if they were referred from the ED, discharge or exitus information were recorded. Results: The consultations of 57 patients referred to rheumatology from the ED were evaluated. 75.4 % (n=43) of the patients referred had previously been diagnosed with an IRD. The most frequently referred patients were those diagnosed with rheumatoid arthritis (17.5 %), Behçet’s disease (14 %) and vasculitis. The most common complaints of patients included musculoskeletal pain (n= 18), fever and malaise (n=15) . The most common diagnoses among patients with IRD were disease flare (n=16) and infection (n=12). Of the patients referred, 28 (49.1%) were hospitalized. None of the patients died during their stay in the emergency department; however, 3 patients died in the inpatient service to which they were referred. Conclusion: The majority of patients evaluated by rheumatologists in the ED have known IRD and are diagnosed with disease activation, infectious pathologies, and drug intoxication. True rheumatologic emergencies are rare, but ED physicians should be aware of serious and life-threatening conditions.