An analysis of inpatient referrals to rheumatology in an irish tertiary referral hospital

Background: Reviewing patients under other services is an important part of the service we deliver in our hospital’s rheumatology department. Objectives: In order to improve quality of the inpatient consult service and relevance of teaching delivered to rheumatology trainees, we wanted to examine the nature of referrals to our service. Methods: All available consults (n=81) were reviewed. The age, gender, urgency and referral source were recorded. The most likely reason for referral as decided by our specialist registrar (research fellow) were determined. Results: 49% of patients were 70 years of age or older. 30% of patients were 70–79 years old. 68% were female. There was a wide range of referrals, 21% were vasculitides (including polymyalgia and giant cell arteritis), 20% inflammatory arthritides, 19% crystal arthropathies, 16% connective tissue disease, 14% osteoarthritis, 3% septic arthritis, 3% fibromyalgia, 3% pyrexia of unknown origin, 1% sarcoid, 1% antphospholipid syndrome and 1% osteoporosis. 59% of consults came from general medical teams, 14% from acute medicine, 14% from surgery, 3% from psychiatry and 11% from other inpatient services (including haematology, oncology etc). 36% of consults were considered urgent (to be seen within 24 hours) by the referring team, 64% were routine (to be seen within 48 hours). Conclusions: Almost half of referrals were over 70 years of age. Most referrals came from medical teams. The majority of consults were women and referred due to a vasculitis, inflammatory arthritis or connective tissue disease. 3% were septic arthritis. Our trainee teaching will now focus primarily on these topics. 3% of referrals were for fibromyalgia, which could perhaps be managed on an outpatient basis. This may improve utilisation of limited inpatient hospital resources. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2018-eular.2233 Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A1721Session: Public health, health services research and health economics