Complejidad de las interconsultas hospitalarias neuro-oncológicas: estudio multicéntrico

IF 2.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia Pub Date : 2025-04-09 DOI:10.1016/j.nrl.2023.09.004

C. Jauregui Larrañaga , M. Villagrán-García , J. Cabello Murgui , M.I. Barceló Artigues , E. Bargay Pizarro , M.C. Gil Alzueta , I. Esparragosa Vázquez , L. Bataller Alberola , R. Velasco Fargas , M.E. Erro Aguirre

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Abstract

Introduction

The oncologic patient may require the evaluation by neurologist when they are admitted at hospital. The aim of our study was to determine the frequency and characteristics of hospital interconsultations (ICh) received by the neurology department concerning oncology patients admitted to the hospital.

Material and methods

A retrospective multicentre study analyzing ICh to neurology concerning onco-hematological patients admitted during five consecutive years (2016-2020) in four tertiary hospitals in Spain was carried out.

Results

A total of 2.091 ICh from 1.710 patients were analysed, most of them male (55.5%; 969/2,091) with a median age of 60.5 years (range 15-92). Most of the ICh came from medical oncology (43.2%; 904/2,091) and hematology (42.2%; 882/2,091) departments. Neuro-oncological ICh accounted for approximately 17% (2,091/12,242) of the total number of ICh performed in the neurology department during the five years included in this study. The most frequent reasons for consultation were limb motor deficit (18.3%; 381/2,077), confusional syndrome (14.1%; 292/2,077), epileptic seizures (12.2%; 254/2,077) and headache (8.1%; 169/2,077). The most frequent associated tumors were lung cancer (18.3%; 383/2,089), leukemia (19%; 396/2,089), lymphoma (17.1%; 357/2,089) and primary brain tumor (12.1%; 353/2,089). The majority (69.9%; 1,460/2,089) of patients were undergoing active or recent cancer treatment. Final neurological diagnoses included metabolic encephalopathy (11.2%; 234/2,091), tumor progression (11%; 231/2,091), cerebral vascular complications (10.1%; 212/2,091), metastases (9.1%; 191/2,091) and leptomeningeal dissemination (8.9%; 186/2,091). 15.4% (323/2,091) of the IChs were closed with an undetermined diagnosis. The median time that the ICh required to be open was 3 days (range 1-152).

Conclusions

The ICh of onco-haematological patients are heterogeneous, with an increasing incidence and complexity, requiring management by neurologists with experience in neuro-oncological patient.

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神经肿瘤医院间会诊的复杂性：多中心研究

肿瘤患者在入院时可能需要神经科医生的评估。我们研究的目的是确定神经内科接收的住院肿瘤患者的医院会诊（ICh）的频率和特征。材料与方法对西班牙四家三级医院连续5年（2016-2020年）住院肿瘤血液病患者的脑出血与神经病学进行回顾性多中心研究。结果1710例患者共检出ICh 2.091例，以男性居多（55.5%）；969/ 2091)，中位年龄60.5岁（范围15-92岁）。大多数ICh来自内科肿瘤学（43.2%）；904/ 2091)和血液学(42.2%；882/2,091)部门。在本研究的五年中，神经肿瘤学脑出血约占神经内科脑出血总数的17%（2091 / 12242）。最常见的咨询原因是肢体运动障碍(18.3%；381/ 2077)，混乱综合征(14.1%；292/ 2077)，癫痫发作(12.2%；254/ 2077)和头痛(8.1%；169/2,077)。最常见的相关肿瘤是肺癌(18.3%；383/ 2089)，白血病(19%；396/ 2089)，淋巴瘤(17.1%；357/ 2089)和原发性脑肿瘤(12.1%；353/2,089)。大多数人(69.9%；1460 / 2089)患者正在积极或近期接受癌症治疗。最终的神经学诊断包括代谢性脑病(11.2%；234/ 2091)，肿瘤进展(11%；231/ 2091)，脑血管并发症(10.1%；212/ 2091)，转移(9.1%；191/ 2091)和脑膜传播(8.9%；186/2,091)。15.4%（323/ 2091）的IChs关闭时诊断不明确。ICh需要开放的中位时间为3天（范围1-152天）。结论血液肿瘤合并脑出血患者的脑出血具有异质性，发病率和复杂性都在增加，需要有神经肿瘤治疗经验的神经科医师进行治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurologia 医学-临床神经学

CiteScore

5.90

自引率

2.60%

发文量

135

审稿时长

48 days

期刊介绍： Neurología es la revista oficial de la Sociedad Española de Neurología y publica, desde 1986 contribuciones científicas en el campo de la neurología clínica y experimental. Los contenidos de Neurología abarcan desde la neuroepidemiología, la clínica neurológica, la gestión y asistencia neurológica y la terapéutica, a la investigación básica en neurociencias aplicada a la neurología. Las áreas temáticas de la revistas incluyen la neurologia infantil, la neuropsicología, la neurorehabilitación y la neurogeriatría. Los artículos publicados en Neurología siguen un proceso de revisión por doble ciego a fin de que los trabajos sean seleccionados atendiendo a su calidad, originalidad e interés y así estén sometidos a un proceso de mejora. El formato de artículos incluye Editoriales, Originales, Revisiones y Cartas al Editor, Neurología es el vehículo de información científica de reconocida calidad en profesionales interesados en la neurología que utilizan el español, como demuestra su inclusión en los más prestigiosos y selectivos índices bibliográficos del mundo.