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Introduction To our knowledge, there have been studies actively looking for patients with suspected SA in the Stroke Unit (SU), but most of them were conducted using a portable polysomnography (PSG), and no study has performed Level 1 PSG (L1PSG) to date. We conducted L1PSG to the acute stroke patients selected in the SU, and conducted L1PSG to patients who visited the Neurology Outpatient Clinic (NOC) with subjective SA symptoms at the same time. By comparison, we tried to find out the SA characteristics of acute stroke patients. Methods This study was conducted on patients admitted to SU from April 1, 2021 to October 31, 2022, and patients who visited NOC during the same period and underwent L1PSG. Among patients admitted to the SU, trained night shift nurses selected patients with SA symptoms with a modified mallampati score of 3 or higher. Cases under intracranial pressure control or other interventions were excluded. Outpatients were enrolled in patients who underwent L1PSG by visiting the NOC to examine only SA. The results of the pre-sleep questionnaire and L1PSG were compared. Results Of a total of 829 stroke patients admitted to SU, 31 SU patients received L1PSG, and during the same period, 74 patients received L1PSG for SA testing at NOC. The average age of SU and NOC was 56 and 57 years, and the median BMI was 26.9 and 26.4. In the survey, the ISI (7 vs 12, p=0.04) and PSQI (5 vs 7, p=0.021) scores were statistically significantly higher in NOC patients. As a result of the L1PSG, AHI (38.8 vs 23.1, p=0.027), AHI in Supine (59.3 vs 25.6, p=0.004) and NonREM AHI (36.3 vs 20.9, p=0.027) were statistically significantly higher in SU patients. Conclusion Patients screened SA at SU overlooked their symptom and thought their sleep quality was better than that of NOC patients, but the actual AHI was higher. In particular, acute stroke patients show a large difference in AHI in supine compared to NOC, so lateral position can be recommended when absolute bed rest is needed in situations where SA is suspected in SU. More follow-up studies will be needed. Support (if any)

BackgroundLymphogranuloma venereum (LGV) is the infection of the lymphatic system caused by Chlamydia trachomatis (CT) serovars L1-L3. The first emergence of LGV in networks of men, who have sex with men (MSM) began in Europe (2003), followed by a series of outbreaks worldwide. In the absence of national passive surveillance systems for LGV, we evaluated prevalence and characteristics of LGV in a high-risk population (MSM) attending a STI Outpatient Clinic in Berlin.MethodsWe performed a retrospective analysis of all tested CT samples (pharyngeal, urethral, rectal) from 2012–2017. All positive rectal samples underwent additional testing for L1-L3 genotype. For this purpose a PCR was performed of a L-specific region (polymorphic H-gene).ResultsA total of 12,390 samples (5,316 patients) were collected and resulted in 486 L+ swabs (191 patients). The number of tested swabs increased from 1,370 (2012) to 3,634 (2017). The proportion of CT+ swabs fluctuated between 10% and 15%. Among the CT+ patients, the proportion of L+ patients decreased continuously from 37% (2012) to 21% (2017). The majority of patients tested were male, between 26–35 years of age. We observed the highest rate of L-infections in older patients (maximum in the age-group 46–55 years, CT+/L+ 46%). The majority of patients infected with L+ came from central metropolitan districts. The HIV-coinfection rate among CT+ patients decreased continuously from 39% (2012) to 12% (2017). The proportion of HIV+ patients among L+ patients remained high and decreased from 80% (2012) to 50% (2017).ConclusionOur data display the largest epidemiological development of LGV in Germany and demonstrate a high prevalence of genotype L1-L3, which require a prolonged antibiotic treatment compared to other CT serotypes. As the routine screening of anorectal swabs in high-risk population is still not recommended, our results strongly suggest a need for genotyping positive CT rectal specimens.DisclosureNo significant relationships.

Aims: It was intended to explore the change in nonattendance rate at outpatient clinics following the introduction of Short Message Service (SMS) reminders in the Black Country Healthcare NHS Foundation Trust, which serves four regions in the West Midlands. Methods: The Trust introduced an SMS system in March 2024 to prompt the patients about their upcoming outpatient appointments. In a mirror-image design, we analysed the Did Not Attend (DNA) rates for 6 months pre and post-SMS introduction, from September 2023 to February 2024 and April 2024 to September 2024 respectively. All the patients offered an outpatient appointment were included in the data collection; with no exclusion. The study was approved by the Research and Innovation team of the Trust as a service evaluation. Results: A total of 14094 appointments were taken into consideration before the introduction of SMS reminders, and a total of 14852 appointments were analysed post-SMS introduction. Before the introduction of SMS reminders, the average DNA rate across all four regions of the Trust was 22.8% (95% CI: 22.2–23.5) with a range of 19.9–24.8 in the six months. After the introduction of SMS reminders, the average DNA rate changed to 23.2% (95% CI: 22.5–23.8) with a range of 21.3–25.1 in the six months; and this change was statistically non-significant (NS). Two regions had an increase of DNA (21.1% to 21.9%, NS; and 20.7% to 24.7%, p<0.05) and others had a decrease (25.2% to 23.1%, p<0.05; and 24.7% to 23.6%, NS). Conclusion: It appeared that within six months of the introduction of the SMS reminder system, there was no significant change in the DNA rates in the Trust; although there were regional variations of both increase and decrease in rates. There are multiple factors that can influence attendance at outpatient clinics such as accessibility, patient-related factors, and the effectiveness of a reminder system. It is also probable that the first six months may be early for the SMS system to establish its potential, and longer-term observational data might be needed. Similarly, the difference in DNA rates between regions cannot be explained without more in-depth data. There was a limitation in finding out whether all the patients were sent or received the reminders. There may be a scope to decrease the number of missed appointments through SMS, but further studies are required. In addition, the effectiveness of local processes of inviting patients and sending reminders needs to be checked.

IntroductionA Triage Clinic was introduced at a medium-sized hospital, in which all new outpatient Gastroenterology referrals are reviewed by a consultant and triaged into one of five pathways: a) direct clinic, b) investigation prior to clinic, c) investigation with plan to discharge if normal, d) dietician-led clinic, e) not appropriate for Gastroenterology. Under the previous system, all referrals were given a direct outpatient Gastroenterology clinic appointment. The Triage Clinic aims to improve the patient journey and efficiency of the outpatient service.MethodsThis retrospective analysis included all 116 patients from one gastroenterologist’s Triage Clinic over a two-month period. This analysis mapped the pathway for each patient reviewed into one of the five categories outlined above, and the proportion of referrals requiring a first Gastroenterology outpatient clinic appointment.ResultsThere was a 53.4% reduction in the number of patients requiring a first outpatient clinic appointment: down to 46.6% (54/116) from 100% under the previous system.6.9% of patients were triaged directly to clinic (8/116), while 31.9% (37/116) had investigations ordered prior to an outpatient clinic appointment. 39.7% (46/116) had investigations ordered with a plan to discharge if normal. of these, 19.6% subsequently had a clinic appointment booked (9/46).5.2% were triaged to dietician-led clinics (6/116), and 16.4% were triaged as not appropriate for Gastroenterology (19/116), and either discharged back to their GP with written advice or referred directly to another specialty. None of these patients were re-referred in the following six-months.Amongst patients proceeding to a first outpatient appointment, 85.1% had investigations prior to their appointment, and 37.8% were discharged after just one appointment.Abstract P311 Figure 1Triage clinic outcomesConclusionsWe found a 53.4% reduction in the proportion of patients referred requiring a first outpatient Gastroenterology clinic appointment following introduction of the Triage Clinic. For patients requiring an outpatient appointment, triage streamlined the patient journey by arranging appropriate investigations prior to clinic. Given rising demand for outpatient Gastroenterology services, a Triage Clinic model could help to improve referral pathways.Following positive informal feedback from primary care clinicians, further analysis will formally evaluate patient and referring clinician experience of the Triage Clinic, and aim to further improve the patient journey for those referred.

The use of a validated tool for risk assessment to inform hospital discharge, combined with rapid follow-up, led to a lower risk of death or hospitalization for cardiovascular causes within 30 days among patients with acute heart failure.