Andreas P Diamantopoulos1, Glenn Haugeberg2, Are Lindland3, Geirmund Myklebust4. 1. Department of Rheumatology, Hospital of Southern Norway Trust Kristiansand, andreas.diamantopoulos@sshf.no. 2. Department of Rheumatology, Hospital of Southern Norway Trust Kristiansand, Department of Neuroscience, Division of Rheumatology, Norwegian University of Science and Technology, Trondheim and. 3. Department of Ophthalmology, Hospital of Southern Norway Trust Arendal, Norway. 4. Department of Rheumatology, Hospital of Southern Norway Trust Kristiansand.
Abstract
OBJECTIVE: Permanent visual impairment has been reported to occur in up to 19% of GCA patients. The aim of this study was to examine whether implementation of a fast-track approach could reduce the rate of permanent visual impairment and inpatient days of care in GCA patients. METHODS: A fast-track outpatient GCA clinic (FTC) was implemented in the Department of Rheumatology, Hospital of Southern Norway Trust Kristiansand, Norway in 2012. The patients included in this study were subsequently recruited between March 2010 and October 2014. Routine clinical and laboratory data and number of inpatient days of care were collected. RESULTS: During the observation period, 75 patients were diagnosed with GCA. Among the 75 GCA patients, 32 were evaluated conventionally and 43 in the FTC. In the conventionally approached group, six patients suffered from permanent visual impairment, while in the FTC group only one patient suffered from permanent visual impairment. The relative risk of permanent visual impairment in the GCA patients examined in the FTC was 88% lower compared with the conventionally evaluated group (relative risk 0.12, 95% CI: 0.01, 0.97, P = 0.01). The mean difference in inpatient days of care between patients evaluated conventionally and patients evaluated in the FTC was 3 days (3.6 vs 0.6 days, P < 0.0005). CONCLUSION: The implementation of the FTC in GCA care appears to significantly reduce the risk of permanent visual impairment and is more cost effective by reducing the need for inpatient care.
OBJECTIVE: Permanent visual impairment has been reported to occur in up to 19% of GCA patients. The aim of this study was to examine whether implementation of a fast-track approach could reduce the rate of permanent visual impairment and inpatient days of care in GCA patients. METHODS: A fast-track outpatient GCA clinic (FTC) was implemented in the Department of Rheumatology, Hospital of Southern Norway Trust Kristiansand, Norway in 2012. The patients included in this study were subsequently recruited between March 2010 and October 2014. Routine clinical and laboratory data and number of inpatient days of care were collected. RESULTS: During the observation period, 75 patients were diagnosed with GCA. Among the 75 GCA patients, 32 were evaluated conventionally and 43 in the FTC. In the conventionally approached group, six patients suffered from permanent visual impairment, while in the FTC group only one patient suffered from permanent visual impairment. The relative risk of permanent visual impairment in the GCA patients examined in the FTC was 88% lower compared with the conventionally evaluated group (relative risk 0.12, 95% CI: 0.01, 0.97, P = 0.01). The mean difference in inpatient days of care between patients evaluated conventionally and patients evaluated in the FTC was 3 days (3.6 vs 0.6 days, P < 0.0005). CONCLUSION: The implementation of the FTC in GCA care appears to significantly reduce the risk of permanent visual impairment and is more cost effective by reducing the need for inpatient care.
Authors: Sara Monti; Alberto Floris; Cristina Ponte; Wolfgang A Schmidt; Andreas P Diamantopoulos; Claudio Pereira; Jennifer Piper; Raashid Luqmani Journal: Rheumatology (Oxford) Date: 2018-02-01 Impact factor: 7.580
Authors: Christian Dejaco; Elisabeth Brouwer; Justin C Mason; Frank Buttgereit; Eric L Matteson; Bhaskar Dasgupta Journal: Nat Rev Rheumatol Date: 2017-09-14 Impact factor: 20.543
Authors: Marieke van Nieuwland; Dennis Boumans; Gerben Jan Jacob Plas; Onno Dirk Vijlbrief; Celina Alves Journal: Eur J Case Rep Intern Med Date: 2021-07-27