Complexity of neuro-oncological in-hospital consultations: a multicentre study

Neurologia Pub Date : 2025-05-01 DOI:10.1016/j.nrleng.2025.04.014

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

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Abstract

Introduction

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

Material and methods

A retrospective multicentre study analysing IC with neurology concerning onco-haematological patients admitted over 5 consecutive years (2016-2020) in 4 tertiary hospitals in Spain was carried out.

Results

A total of 2091 IC from 1710 patients were analysed, most of them male (55.5%; 969/2091) with a median age of 60.5 years (range 15-92). Most of the ICs came from the medical oncology (43.2%; 904/2091) and hematology (42.2%; 882/2091) departments. Neuro-oncological ICs accounted for approximately 17% (2091/12 242) of the total number of ICs performed in the neurology department during the 5 years included in this study. The most frequent reasons for consultation were limb motor deficit (18.3%; 381/2077), confusional syndrome (14.1%; 292/2077), epileptic seizures (12.2%; 254/2077), and headache (8.1%; 169/2077). The most frequent associated tumours were lung cancer (18.3%; 383/2089), leukaemia (19%; 396/2089), lymphoma (17.1%; 357/2089), and primary brain tumor (12.1%; 353/2089). The majority (69.9%; 1460/2089) of patients were undergoing active or recent cancer treatment. Final neurological diagnoses included metabolic encephalopathy (11.2%; 234/2091), tumor progression (11%; 231/2091), cerebral vascular complications (10.1%%; 212/2091), metastases (9.1%%; 191/2091), and leptomeningeal dissemination (8.9%%; 186/2091). A total of 15.4% (323/2091) of the ICs were closed with an undetermined diagnosis. The median time that the ICs were open was 3 days (range, 1-152).

Conclusions

ICs concerning onco-haematological patients are heterogeneous, with an increasing incidence and complexity, requiring management by neurologists with experience in neuro-oncological patients.

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神经肿瘤学院内会诊的复杂性：一项多中心研究

简介：肿瘤患者入院时可能需要由神经科医生进行评估。我们研究的目的是确定神经内科接收到的住院肿瘤患者的医院会诊频率和特征。材料和方法：对西班牙4家三级医院连续5年（2016-2020年）住院的肿瘤合并血液病患者的神经内科IC进行回顾性多中心研究。结果：共分析1710例患者的2091例IC，其中男性居多(55.5%；969/2091)，中位年龄60.5岁（范围15-92岁）。内科肿瘤科占比最高（43.2%）；904/2091)和血液学(42.2%；882/2091)部门。在本研究纳入的5年中，神经肿瘤科的ic约占神经内科ic总数的17%（2091/12 242）。最常见的咨询原因是肢体运动障碍(18.3%；381/2077)，精神错乱综合征(14.1%；292/2077)，癫痫发作(12.2%；254/2077)，头痛(8.1%；169/2077)。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)，原发性脑肿瘤(12.1%；353/2089)。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)，脑膜传播(8.9%；186/2091)。共有15.4%（323/2091）的ic在诊断不明确的情况下关闭。ic开放的中位数时间为3天（范围，1-152）。结论：肿瘤合并血液病患者的ic是异质性的，发病率和复杂性都在增加，需要有治疗神经肿瘤患者经验的神经科医生进行管理。

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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Neurologia

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53 weeks