Infarto agudo de miocardio asociado con ictus subagudo bilateral cardioembólico en el territorio de la arteria cerebral anterior: la cara oculta de una fibrilación auricular de novo / Acute myocardial infarction associated with bilateral subacute cardioembolic stroke in the anterior cerebral artery territory: The hidden face of a new-onset atrial fibrillation

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Biterapia inmunosupresora efectiva e innovadora en un síndrome opsoclono-mioclono-ataxia paraneoplásico e inusual del adulto / Innovative and effective immunosuppressive bitherapy for an unusual paraneoplastic opsoclonus-myoclonus-ataxia syndrome of the adult

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Diplopía vertical binocular tras laberintectomía química con gentamicina. A propósito de un caso y revisión de la literatura / Binocular vertical diplopia following chemical labyrinthectomy with gentamicin: A case report and review of literature

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Utilización de recursos sanitarios y costes asociados al manejo de los pacientes con infarto cerebral cardioembólico agudo en la Comunidad de Madrid: Estudio CODICE / Use of healthcare resources and costs of acute cardioembolic stroke management in the Region of Madrid: The CODICE Study

Introducción: El ictus es la principal causa de ingreso en los servicios de Neurología, siendo el infarto cerebral cardioembólico (ICE) de los subtipos más frecuentes. Métodos: Estudio observacional, multicéntrico, prospectivo, realizado en 5 hospitales públicos de la Comunidad de Madrid, cuyo objetivo fue estimar la utilización de recursos sanitarios y costes en el manejo del ICE agudo. Se incluyeron pacientes con ICE agudo de evolución < 48 h. Se registraron datos sociodemográficos, clínicos y los recursos sanitarios utilizados durante el ingreso y al alta hasta 30 días desde el ingreso, incluyendo el tratamiento rehabilitador al alta. Resultados: Se seleccionaron 128 pacientes durante 8 meses, de 75,3 ± 11,25 años, siendo un 46,9% mujeres, con una mortalidad del 4,7%. El 100% cumplía los criterios diagnósticos del GEENCV-SEN por antecedentes o el estudio realizado. Como antecedentes clínicos, el 50% presentó fibrilación auricular, y el 18,8%, otras fuentes mayores embolígenas. La fibrilación auricular no valvular fue la causa más frecuente de ICE (33,6%). Consumo de recursos: estancia media, 10,3 ± 9,3 días; rehabilitación durante el ingreso, 46,9%, media 4,5 días, y al alta, 56,3%, media 26,8 días; complicaciones, 32%; intervenciones hospitalarias específicas, 19,5%; pruebas diagnósticas y analíticas sanguíneas, 100%, siendo la TAC craneal (98,4%), el dúplex TSA (87,5%) y el electrocardiograma (85,9%), las diagnósticas más frecuentes. El coste total medio por paciente en la fase aguda y rehabilitación por ICE fue de 13.139 Euros, siendo la estancia hospitalaria (45,0%) y la rehabilitación al alta (29,2%) los recursos más importantes. Conclusiones: El manejo agudo del ICE en la Comunidad de Madrid generó un importante consumo de recursos (13.139 Euros) debido a la asistencia hospitalaria y la rehabilitación

Introduction: Stroke is the main cause of admission to Neurology departments and cardioembolic stroke (CS) is one of the most common subtypes of stroke. Methods: A multicentre prospective observational study was performed in 5 Neurology departments in public hospitals in the Region of Madrid (Spain). The objective was to estimate the use of healthcare resources and costs of acute CS management. Patients with acute CS at < 48 h from onset were recruited. Patients’ socio-demographic, clinical, and healthcare resource use data were collected during hospitalisation and at discharge up to 30 days after admission, including data for rehabilitation treatment after discharge. Results: During an 8-month recruitment period, 128 patients were recruited: mean age, 75.3 ± 11.25; 46.9% women; mortality rate, 4.7%. All patients met the CS diagnostic criteria established by GEENCV-SEN, based on medical history or diagnostic tests. Fifty per cent of the patients had a history of atrial fibrillation and 18.8% presented other major cardioembolic sources. Non-valvular atrial fibrillation was the most frequent cause of CS (33.6%). Data for healthcare resource use, given a mean total hospital stay of 10.3 ± 9.3 days, are as follows: rehabilitation therapy during hospital stay (46.9%, mean 4.5 days) and after discharge (56.3%, mean 26.8 days), complications (32%), specific interventions (19.5%), and laboratory and diagnostic tests (100%). Head CT (98.4%), duplex ultrasound of supra-aortic trunks (87.5%), and electrocardiogram (85.9%) were the most frequently performed diagnostic procedures. Average total cost per patient during acute-phase management and rehabilitation was Euros 13,139. Hospital stay (45.0%) and rehabilitation at discharge (29.2%) accounted for the largest part of resources used. Conclusions: Acute CS management in the Region of Madrid resulted consumes large amounts of resources (Euros 13,139), mainly due to hospital stays and rehabilitation

Use of healthcare resources and costs of acute cardioembolic stroke management in the Region of Madrid: The CODICE Study.

INTRODUCTION: Stroke is the main cause of admission to Neurology departments and cardioembolic stroke (CS) is one of the most common subtypes of stroke. METHODS: A multicentre prospective observational study was performed in 5 Neurology departments in public hospitals in the Region of Madrid (Spain). The objective was to estimate the use of healthcare resources and costs of acute CS management. Patients with acute CS at<48h from onset were recruited. Patients' socio-demographic, clinical, and healthcare resource use data were collected during hospitalisation and at discharge up to 30 days after admission, including data for rehabilitation treatment after discharge. RESULTS: During an 8-month recruitment period, 128 patients were recruited: mean age, 75.3±11.25; 46.9% women; mortality rate, 4.7%. All patients met the CS diagnostic criteria established by GEENCV-SEN, based on medical history or diagnostic tests. Fifty per cent of the patients had a history of atrial fibrillation and 18.8% presented other major cardioembolic sources. Non-valvular atrial fibrillation was the most frequent cause of CS (33.6%). Data for healthcare resource use, given a mean total hospital stay of 10.3±9.3 days, are as follows: rehabilitation therapy during hospital stay (46.9%, mean 4.5 days) and after discharge (56.3%, mean 26.8 days), complications (32%), specific interventions (19.5%), and laboratory and diagnostic tests (100%). Head CT (98.4%), duplex ultrasound of supra-aortic trunks (87.5%), and electrocardiogram (85.9%) were the most frequently performed diagnostic procedures. Average total cost per patient during acute-phase management and rehabilitation was €13,139. Hospital stay (45.0%) and rehabilitation at discharge (29.2%) accounted for the largest part of resources used. CONCLUSIONS: Acute CS management in the Region of Madrid resulted consumes large amounts of resources (€13,139), mainly due to hospital stays and rehabilitation.