Epidemiology and Clinical Profile of Neurologic Patients Evaluated In the Emergency Department of Teaching Hospital in Mogadishu, Somalia, Cross-sectional Study

Abstract Neurologic disorders are common reasons for emergency consultations. The majority of neurologic disease manifestations in the emergency room (ER) are life-threatening and require urgent treatment. The goal of this study is to investigate the epidemiology and clinical characteristics of different neurological disorders among emergency department admissions in Mogadishu.This is a cross sectional study conducted in the emergency department of Mogadishu Somali Turkish Training and Research Hospital from July 2021 to February 2022. The clinical and epidemiological characteristics of adult patients with neurologic manifestations in the emergency room were evaluated. Age, gender, distribution of neurological disease manifestations, neurological examination findings, and neurological diagnoses made by consultant neurologists were assessed. During the study period, 321 patients out of 8,500 were included in the study accounting for 3.7 percent of all emergency admissions. The majority of the patients in the study were 50 years of age or older (59%). The male subjects accounted for 56% of the total, while females accounted for 44%. Hypertension was the most common co-morbidity among subjects (38%), followed by diabetes mellitus and heart disease. The admission rate was high (78.2%) after neurological evaluation. The most common reason for a neurology consultation (43.9%) was altered mental status, followed by motor deficits and seizures. Ischemic and hemorrhagic strokes were the most common diagnoses after neurological evaluation (38.9% and 20.2%, respectively). Among subjects evaluated due to altered mental status, stroke was the most common diagnosis, followed by encephalopathy and status epilepticus. Patients with neurological manifestations in the ER require a multidisciplinary approach. This study illustrates the pattern of neurological emergencies in Somalia’s largest referral hospital and also highlights the significance of neurological assessment by a neurologist in the ER. In our study, hemorrhagic and ischemic strokes were the most prevalent neurologic presentations in the ER, particularly among the elderly.