Clinical and demographical aspects of a new neurology outpatient clinic in a developing country: a descriptive retrospective study

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Background: Neurological disorders are among the leading causes of disability-adjusted life years and the second leading cause of death globally, posing a major public health challenge-especially in low- and middle-income countries. This study aimed to identify the clinical and epidemiological profiles of patients seen at a newly established neurology outpatient clinic in Brazil, assess the appropriateness of referrals and describe follow-up times and diagnostic patterns. Methods: This retrospective study reviewed medical records from 1635 patients treated between May 2017 and June 2022. Data collection involved two phases: first, an electronic system extraction and second, a detailed manual review of each record to ensure accuracy. Diagnoses were coded using the ICD 10 (International Statistical Classification of Diseases and Related Health Problems), and presenting complaints were categorised into 14 clinical groups. Results: Among the 1635 patients reviewed, 80% received a neurological diagnosis. The two most frequent conditions were neurovascular diseases (23.4%) and migraine (21.4%). A substantial proportion of patients, 69.5%, presented with at least one comorbidity. Hypertension (40.5%) and diabetes mellitus (18.5%) were the most frequent conditions. Compared with patients with cerebrovascular disorders, those diagnosed with migraine or other headache syndromes had significantly lower odds of having hypertension (OR 0.26; 95% CI 0.14 to 0.48) and diabetes (OR 0.26; 95% CI 0.14 to 0.48). Other diagnostic categories also followed this trend, with consistently lower odds of comorbidities in comparison to cerebrovascular disorders. Additionally, 4.2% of referrals were deemed inappropriate, and of these, 71% were directed to general neurology rather than specialised services. Conclusion: This study reveals a distinct clinical profile of neurological patients that diverges from national and international benchmarks, highlighting the unique demographic and health characteristics of the population served. These results deepen our understanding of both clinical and social needs in neurological care and offer valuable benchmarks for comparable services worldwide. By mapping diagnostic patterns, comorbidity burdens and referral practices, the study aligns with several United Nations Sustainable Development Goals (SDG). These findings can inform public health strategies, particularly in resource-limited settings, to implement more equitable and efficient neurological care, promote targeted prevention and management of chronic comorbidities, and optimise referral systems. Such action would contribute meaningfully to SDG targets, fostering health equity and advancing sustainable neurological services.

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