Gabriel Bsteh, Stefan Macher, Nik Krajnc, Wolfgang Marik, Martin Michl, Nina Müller, Sina Zaic, Jürgen Harreiter, Klaus Novak, Christian Wöber, Berthold Pemp
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Here, the aim was to evaluate the effects of this one-stop concept on objective clinical outcome.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In a retrospective cohort study, the one-stop era with integrated care (IC) (1 July 2021 to 31 December 2022) was compared to a reference group receiving standard care (SC) (1 July 2018 to 31 December 2019) regarding visual impairment/worsening and headache improvement/freedom 6 months after diagnosis. Multivariate binary logistic regression models were used to adjust for confounders.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Baseline characteristics of the IC group (<i>n</i> = 85) and SC group (<i>n</i> = 81) were comparable (female 90.6% vs. 90.1%; mean age 33.6 vs. 32.8 years; median body mass index 31.8 vs. 33.0; median cerebrospinal fluid opening pressure 32 vs. 34 cmH<sub>2</sub>O; at diagnosis, visual impairment was present in 71.8% vs. 69.1% and chronic headache in 55.3% vs. 56.8% in IC vs. SC). IC was associated with a higher likelihood of achieving both headache improvement (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.52–4.33, <i>p</i> < 0.001) and headache freedom (OR 1.75, 95% CI 1.11–3.09, <i>p</i> = 0.031). Regarding the risk of visual impairment and visual worsening IC was superior numerically but not statistically significantly (OR 0.87, 95% CI 0.69–1.16, <i>p</i> = 0.231, and OR 0.67, 95% CI 0.41–1.25, <i>p</i> = 0.354).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Interdisciplinary integrated care of IIH is favourably associated with headache outcomes and potentially also visual outcomes.</p>\n </section>\n </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16401","citationCount":"0","resultStr":"{\"title\":\"An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension—a comprehensive assessment of clinical outcome\",\"authors\":\"Gabriel Bsteh, Stefan Macher, Nik Krajnc, Wolfgang Marik, Martin Michl, Nina Müller, Sina Zaic, Jürgen Harreiter, Klaus Novak, Christian Wöber, Berthold Pemp\",\"doi\":\"10.1111/ene.16401\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and purpose</h3>\\n \\n <p>Management of idiopathic intracranial hypertension (IIH) is complex requiring multiple specialized disciplines. 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引用次数: 0
摘要
背景和目的：特发性颅内高压（IIH）的治疗非常复杂，需要多个专业学科的参与。在实践中，这给医护人员和患者的组织和沟通带来了相当大的挑战。因此，特发性颅内高压的跨学科综合门诊（包括神经内科、神经眼科、神经放射科、神经外科和内分泌科）在中央协调和一站式理念的指导下成立了。本文旨在评估一站式理念对客观临床结果的影响：在一项回顾性队列研究中，就确诊 6 个月后视力损伤/恶化和头痛改善/缓解的情况，将采用综合护理（IC）的一站式时代（2021 年 7 月 1 日至 2022 年 12 月 31 日）与接受标准护理（SC）的参照组（2018 年 7 月 1 日至 2019 年 12 月 31 日）进行了比较。多变量二元逻辑回归模型用于调整混杂因素：IC组（n = 85）和SC组（n = 81）的基线特征具有可比性（女性占90.6% vs. 90.1%；平均年龄33.6岁 vs. 32.8岁；中位体重指数31.8 vs. 33.0；中位脑脊液开放压32 vs. 34 cmH2O；确诊时，IC vs. SC中71.8% vs. 69.1%存在视力障碍，55.3% vs. 56.8%存在慢性头痛）。IC与头痛同时得到改善的可能性较高（比值比 [OR] 2.24，95% 置信区间 [CI] 1.52-4.33，P 结论：IC与头痛同时得到改善的可能性较高：IIH的跨学科综合治疗与头痛疗效以及视力疗效的潜在相关性较高。
An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension—a comprehensive assessment of clinical outcome
Background and purpose
Management of idiopathic intracranial hypertension (IIH) is complex requiring multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges for healthcare professionals and patients. Thus, an interdisciplinary integrated outpatient clinic for IIH (comprising neurology, neuroophthalmology, neuroradiology, neurosurgery and endocrinology) was established with central coordination and a one-stop concept. Here, the aim was to evaluate the effects of this one-stop concept on objective clinical outcome.
Methods
In a retrospective cohort study, the one-stop era with integrated care (IC) (1 July 2021 to 31 December 2022) was compared to a reference group receiving standard care (SC) (1 July 2018 to 31 December 2019) regarding visual impairment/worsening and headache improvement/freedom 6 months after diagnosis. Multivariate binary logistic regression models were used to adjust for confounders.
Results
Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female 90.6% vs. 90.1%; mean age 33.6 vs. 32.8 years; median body mass index 31.8 vs. 33.0; median cerebrospinal fluid opening pressure 32 vs. 34 cmH2O; at diagnosis, visual impairment was present in 71.8% vs. 69.1% and chronic headache in 55.3% vs. 56.8% in IC vs. SC). IC was associated with a higher likelihood of achieving both headache improvement (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.52–4.33, p < 0.001) and headache freedom (OR 1.75, 95% CI 1.11–3.09, p = 0.031). Regarding the risk of visual impairment and visual worsening IC was superior numerically but not statistically significantly (OR 0.87, 95% CI 0.69–1.16, p = 0.231, and OR 0.67, 95% CI 0.41–1.25, p = 0.354).
Conclusions
Interdisciplinary integrated care of IIH is favourably associated with headache outcomes and potentially also visual outcomes.
期刊介绍：
The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).
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