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Clinical utility of electrodiagnostic studies in the inpatient setting
Nerve conduction studies and electromyograms (EMGs) are most often performed in the outpatient setting in patients with suspected neuromuscular diseases, where they help the physician confirm the clinical diagnosis, assess the localization and severity of the disease, and plan further evaluation and treat- ment. Not infrequently, EMGs are requested on a relatively urgent basis for patients who are admitted to the hospital. Inpatient electrodiagnostic studies are usually requested in two situations: (1) as part of the diagnostic evaluation of patients who present with symptoms of a neuromuscular disorder; or (2) in patients who are admitted to the hospital with non-neuromuscular illnesses but develop symptoms suggestive of a neuromuscular disorder during the course of their illness. The second scenario com- monly occurs in patients who are in the intensive care unit and are unable to be weaned from the ven- tilator. This raises the possibility of a neuromuscular disorder as a cause of respiratory muscle weakness and ventilator dependence.
The role of EMG in the evaluation of neuro- muscular disorders in the inpatient setting has not been studied previously. In this study, we evaluated the contribution of EMG to the diagnosis and man- agement of hospital inpatients. We hypothesized that inpatient EMGs (IP-EMGs) would frequently find clinically meaningful diagnoses that would affect the subsequent management of patients. The aims of this study were to compare the results of IP-EMGs with the referring physicians’ clinical diag- noses and to assess how often results of IP-EMGs changed the clinical diagnosis and altered further diagnostic evaluation and treatment