Chronic fatigue syndrome in the emergency department
Open Access
- 1 January 2019
- journal article
- research article
- Published by Taylor & Francis Ltd in Open Access Emergency Medicine
- Vol. ume 11, 15-28
- https://doi.org/10.2147/oaem.s176843
Abstract
Purpose: Chronic fatigue syndrome (CFS) is a debilitating disease characterized by fatigue, postexertional malaise, cognitive dysfunction, sleep disturbances, and widespread pain. A pilot, online survey was used to determine the common presentations of CFS patients in the emergency department (ED) and attitudes about their encounters. Methods: The anonymous survey was created to score the severity of core CFS symptoms, reasons for going to the ED, and Likert scales to grade attitudes and impressions of care. Open text fields were qualitatively categorized to determine common themes about encounters. Results: Fifty-nine percent of respondents with physician-diagnosed CFS (total n=282) had gone to an ED. One-third of ED presentations were consistent with orthostatic intolerance; 42% of participants were dismissed as having psychosomatic complaints. ED staff were not knowledgeable about CFS. Encounters were unfavorable (3.6 on 10-point scale). The remaining 41% of subjects did not go to ED, stating nothing could be done or they would not be taken seriously. CFS subjects can be identified by a CFS questionnaire and the prolonged presence (>6 months) of unremitting fatigue, cognitive, sleep, and postexertional malaise problems. Conclusion: This is the first investigation of the presentation of CFS in the ED and indicates the importance of orthostatic intolerance as the most frequent acute cause for a visit. The self-report CFS questionnaire may be useful as a screening instrument in the ED. Education of ED staff about modern concepts of CFS is necessary to improve patient and staff satisfaction. Guidance is provided for the diagnosis and treatment of CFS in these challenging encounters.Keywords
This publication has 55 references indexed in Scilit:
- A pilot registry of unexplained fatiguing illnesses and chronic fatigue syndromeBMC Research Notes, 2013
- Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluationFrontiers in Physiology, 2013
- Fatigue is a Brain-Derived Emotion that Regulates the Exercise Behavior to Ensure the Protection of Whole Body HomeostasisFrontiers in Physiology, 2012
- Myalgic encephalomyelitis: International Consensus CriteriaJournal of Internal Medicine, 2011
- Impaired cardiac function in chronic fatigue syndrome measured using magnetic resonance cardiac taggingJournal of Internal Medicine, 2011
- Migraine headaches in Chronic Fatigue Syndrome (CFS): Comparison of two prospective cross-sectional studiesBMC Neurology, 2011
- The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom SeverityArthritis Care & Research, 2010
- An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndromeBMC Medicine, 2009
- Psychiatric Comorbidity in Persons With Chronic Fatigue Syndrome Identified From the Georgia PopulationPsychosomatic Medicine, 2009
- The american college of rheumatology 1990 criteria for the classification of fibromyalgiaArthritis & Rheumatism, 1990