• 83% of referrals were neurological, mainly headache disorders • 13% were non-neurological, mostly BPPV and syncope • One-quarter were referrals to explain prior tests • ED referrals increased admission risk Rapid-access neurology (“hot clinic”) pathways provide timely specialist assessment for urgent neurological complaints. Evidence from middle-income settings remains scarce. We conducted a 12-month retrospective evaluation of consecutive referrals to a rapid-access neurology pathway (target: 24–48 hours) at a tertiary center in Buenos Aires, Argentina (June 2022–May 2023). We described referral reasons, final main diagnoses grouped into predefined syndromic categories, non-neurological presentations, and short-term disposition (admission vs. discharge). Multivariable logistic and modified Poisson regression estimated adjusted odds ratios (aORs) and risk ratios (aRRs) for admission and neurological vs. non-neurological presentations, adjusting for age, sex, referral source, and syndromic category. Among 1,714 visits (mean age 55.2 years; 58.9% women), 69.1% originated from the emergency department (ED). Overall, 83.0% involved a neurological condition, with leading syndromic diagnoses including headache/facial pain (35.4%), peripheral neuropathies (8.5%), and cognitive syndromes (4.5%). Non-neurological presentations accounted for 13.2%, mainly benign paroxysmal positional vertigo and syncope/collapse. One-quarter (25.3%) were referrals to explain prior tests. Admission rate was 7.4%, chiefly for vascular syndromes, headache, and delirium. Adjusted models showed ED referral increased admission risk (aRR 1.47, 95% CI 1.00–2.17) and neurological diagnosis likelihood (aRR 1.63, 95% CI 1.18–2.26), while test-explanation referrals reduced admission risk (aRR 0.21, 95% CI 0.06–0.62). In a middle-income tertiary setting, this rapid-access neurology pathway managed mostly neurological presentations with low admission rates, but substantial activity stemmed from nonselective testing and non-neurological issues. Standardized criteria, training, and imaging stewardship could enhance access for urgent cases and reduce unnecessary utilization.
Putalivo et al. (Sun,) studied this question.