Login to Access Video or Poster Abstract: MP85-10
Sources of Funding: None

Introduction

The majority of spina bifida patients are now living to adulthood, but 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 admitting diagnosis._x000D_

Methods

A retrospective review of all patients with a diagnosis of spina bifida (SB) and neurogenic bladder presenting to the Northwestern University Hospital ER from 2008-2015 was conducted. Information on chief complaint, admitting diagnosis, admission disposition, and imaging utilization was collected._x000D_

Results

231 patients were identified that met study criteria. The chief complaint was abdominal pain/nausea/vomiting/diarrhea in 33, headache/shunt issues in 30, skin issues or pressure sores in 25, chills/fevers of unknown origin in 22, urinary tract infection (upper or lower) in 22, back/flank pain in 16 (with known nephrolithiasis in 5), catheter issues in 13, chest pain/cough in 12, post-operative complications in 8, and dialysis complications in 7, with the remainder comprising a variety of complaints. Of the 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._x000D_

Conclusions

Adult spina bifida patients present to the emergency with varied chief complaints. The overwhelming majority are admitted for in-patient 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 often non-urologic chief complaints._x000D_

Funding

None