AB0819 PROFILE OF RHEUMATOLOGIC EMERGENCIES IN THE DEPARTMENT OF RHEUMATOLOGY OF THE UNIVERSITY HOSPITAL OF IBN ROCHD IN 2019
Authors: Z. El Ouali, S. Lahrichi, R. Assadi, K. Nassar, S. Janani
Journal: Annals of the Rheumatic Diseases (2021)

Background: Rheumatology is a medical field often referred to as “cool” because of the low frequency of life-threatening pathologies in common practice (1). However, rheumatologists may be solicited to manage situations that are often depicted as urgent from the point of view of the patient. Objectives: To profile the consultations received in the emergency unit of the Department of Rheumatology of the University Hospital of Ibn Rochd in Casablanca. Methods: We conducted a retrospective study on the 2019 emergency consultations register of the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We collected epidemiological, clinical, and therapeutic data. Results: 407 emergency consultations were carried out in 2019. The average age of the patients was 50.7 (range 14 - 88). 20% of the consultants were 65 years old or older. The sex ratio M/F was 0.4. 95.6% of the patients were from the Casablanca-Settat region. 86.4% of the patients came from the emergency department of the hospital, 10.6% came from other intra-hospital services, and 3% were referred directly to our department. The most represented socio-professional categories were respectively people without professional activity other than retirees (67.6%), followed by intermediate professions (9.7%), executives and higher intellectual professions (5.8%), and retirees (5.3%). Regarding social insurance, 49.4% of the consultants benefited from a public health assistance scheme, 30% had a public health insurance, 14.4% had no health insurance, and 9.9% had a private health insurance. The most frequent reasons for consultation were polyarthralgia (26.8%), oligoarthralgia (18.9%), low back pain (22.6%), lumbar radiculalgia (16.7%), monoarthralgia (11,8%), neck pain (8.1%), cervicobrachial neuralgia (6.4%), monoarthritis (5.4%), polyarthritis (3.4%), and oligoarthritis (2,7%). The general condition of the patients was good in 83% of cases, 5.2% had asthenia, 4.4% had a fever above 38°C, and 3.7% had anorexia. Extra-articular signs were present in 24.7% of cases. At the end of the consultation, a diagnosis could be made in 57.2% of cases. The diagnoses comprised degenerative (51%), inflammatory rheumatic (8.6%), infectious (7.3%), metabolic (6.7%), and tumor (2.1%) pathologies. The main treatments prescribed were level 1 analgesics in 65.6% of cases, non-steroidal anti-inflammatory drugs in 45% of cases, local treatment in 28.9% of cases, symptomatic slow-acting drugs in 21.9% of cases, muscle relaxants in 17% of cases, rest in 12.5% of cases, and supportive orthotics in 11.6% of cases. Regarding the outcomes of the consultants, 75.4% were referred to a conventional hospital consultation for rheumatology follow-up, 13.6% of patients were referred to other specialized departments, 9.1% of patients were lost to follow-up, and 3.9% were hospitalized in our department. Conclusion: The polyarthralgia and the low back pain were the most frequent reasons for consultation in our rheumatology emergency unit. Degenerative pathology is in the lead of the etiologies. Level I analgesics and non-steroidal anti-inflammatory drugs play an important role in symptomatic emergency treatments. References: [1]Gutiérrez-González LA. Rheumatologic emergencies. Clin Rheumatol. 2015 Dec;34(12):2011–9. Disclosure of Interests: None declared