Complejidad de las interconsultas hospitalarias neuro-oncológicas: estudio multicéntrico

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 60.5years (range 15-92). Most of the ICh came from medical oncology (43.2%; 904/2,091) and hematology (42.2%; 882/2,091) departments. Neurooncological 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 neurooncological patient. (c) 2025 Sociedad Espanola de Neurolog& imath;a. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).