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1. 21434. SUSPENSIÓN DE TERAPIA ANTI-CD20 EN PACIENTES CON ESCLEROSIS MÚLTIPLE MAYORES DE 55 AÑOS

Author

R. Carvajal Junco, C. Fadrique, M. Molina, S. Otero Romero, C. Tur Gómez, P. Carbonell Mirabent, A. Cobo Calvo, H. Ariño Rodríguez, G. Arrambide García, L. Bollo, J. Castilló Justribó, M. Comabella López, I. Galán Cartaña, M. García Sarreón, D. Lapuma, C. Marcialis, L. Midaglia Fernández, A. Pappolla, M. Rodríguez Barranco, B. Rodríguez Acevedo, J. Río Izquierdo, P. Tagliani, A. Vidal Jordana, A. Vilaseca Jolonch, A. Zabalza de Torres, J. Sastre Garriga, X. Montalban Gairín, and M. Tintoré Subirana

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2024
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2. 21445. INMUNIDAD HUMORAL PREEXISTENTE CONTRA EL SARAMPIÓN Y EL VIRUS DE LA VARICELA-ZÓSTER EN PACIENTES CON ESCLEROSIS MÚLTIPLE TRAS LA EXPOSICIÓN A TERAPIAS ANTI-CD20: ¿SE PIERDE LA PROTECCIÓN?

Author

R. Carvajal Junco, C. Tur Gómez, P. Carbonell Mirabent, A. Cobo Calvo, H. Ariño Rodríguez, M. Aroca Alsina, G. Arrambide García, L. Bollo, G. Bravo, S. Cárdenas Robledo, J. Castilló Justribó, M. Comabella López, J. Esperalba, I. Galán Cartaña, M. García Sarreón, C. Guio Sánchez, D. Lapuma, L. Midaglia Fernández, A. Pappolla, M. Robles Sánchez, M. Rodríguez Barranco, B. Rodríguez Acevedo, J. Río Izquierdo, P. Tagliani, A. Vidal Jordana, A. Vilaseca Jolonch, A. Zabalza de Torres, J. Sastre Garriga, X. Montalban Gairín, M. Tintoré Subirana, and S. Otero Romero

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2024
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3. 21436. NEUMONÍA ORGANIZADA SECUNDARIA ASOCIADA A LA INFECCIÓN POR COVID-19 EN PACIENTES CON ENFERMEDADES DESMIELINIZANTES INFLAMATORIAS DEL SISTEMA NERVIOSO CENTRAL TRATADOS CON TERAPIAS ANTI-CD20

Author

R. Carvajal Junco, B. Rodríguez Acevedo, L. García Vasco, A. Zabalza de Torres, H. Ariño Rodríguez, L. Bollo, N. Cabello Clotet, J. Castilló Justribó, A. Cobo Calvo, M. Comabella López, A. Falco Roget, I. Galán Cartaña, M. García Sarreón, I. Gómez Estévez, G. Granados, D. Lapuma, G. Mato Chain, L. Midaglia Fernández, A. Nieto García, S. Otero Romero, A. Pappolla, M. Rodríguez Barranco, J. Río Izquierdo, P. Tagliani, C. Tur Gómez, A. Vidal Jordana, A. Vilaseca Jolonch, A. Villar, J. Sastre Garriga, C. Oreja Guevara, M. Tintoré Subirana, X. Montalban Gairín, and G. Arrambide García

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2024
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4. 21108. MODELADO DEL RIESGO DE INFECCIÓN EN ESCLEROSIS MÚLTIPLE: EVENTOS INICIALES Y RECURRENTES EN UN ESTUDIO DE COHORTE EMPAREJADO BASADO EN POBLACIÓN EN CATALUÑA

Author

C. Guio Sánchez, S. Cárdenas Robledo, C. Tur Gómez, P. Carbonell Mirabent, R. Carvajal Junco, A. Cobo Calvo, I. Ruiz Camps, A. Albasanz Puig, A. Falcó Roget, D. Romero Herrero, J. Trejo, B. Borras, J. Río Izquierdo, J. Castilló Justribó, N. Mongay Ochoa, A. Vidal Jordana, G. Arrambide García, V. Fernández, B. Rodríguez Acevedo, A. Zalbalza de Torres, L. Midaglia Fernández, L. Bollo ., N. Braga, A. Vilaseca Jolonch, H. Ariño Rodríguez, A. Pappolla, I. Galán Cartaña, M. Comabella López, J. Sastre Garriga, X. Montalban Gairín, M. Tintoré Subirana, and S. Otero Romero

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2024
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5. 21092. MEDIR LA CADENA LIGERA DE LOS NEUROFILAMENTOS MEJORA LA CAPACIDAD PREDICTIVA DE LOS SCORES DE RESPUESTA AL TRATAMIENTO EN ESCLEROSIS MÚLTIPLE

Author

V. Fernández, A. Pappolla, P. Carbonell Mirabent, M. Rodríguez Barranco, M. Castillo Juárez, L. Gutiérrez, N. Fissolo, H. Ariño Rodríguez, C. Auger, L. Bollo, J. Castilló Justribó, A. Cobo Calvo, C. Espejo Ruiz, I. Galán Cartaña, C. Guio Sánchez, D. Lapuma, L. Midaglia Fernández, N. Mongay Ochoa, C. Nos Llopis, S. Otero Romero, B. Rodríguez Acebedo, J. Sastre Garriga, P. Tagliani, C. Tur Gómez, A. Vidal Jordana, A. Vilaseca Jolonch, J. Villacieros Álvarez, A. Zabalza de Torres, A. Rovira Cañellas, M. Tintoré Subirana, M. Comabella López, J. Río Izquierdo, X. Montalban Gairín, and G. Arrambide

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2024
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7. 21100. EL VALOR AÑADIDO DE NIVELES ELEVADOS EN SUERO DE LA CADENA LIGERA DE LOS FILAMENTOS PARA PREDECIR ESCLEROSIS MÚLTIPLE AGRESIVA EN SÍNDROMES CLÍNICOS AISLADOS

Author

M. García Sarreón, E. Reinders, C. Tur Gómez, M. Rodríguez Barranco, N. Fissolo, M. Castillo Juárez, L. Gutiérrez, M. Alberich, R. Carvajal Junco, A. Pappolla, L. Bollo, A. Cobo Calvo, J. Villacieros Álvarez, A. Zabalza de Torres, H. Ariño Rodríguez, P. Tagliani, A. Vilaseca Jolonch, D. Lapuma, A. Vidal Jordana, B. Rodríguez Acebedo, J. Castilló Justribó, I. Galán Cartaña, J. Río Izquierdo, A. Rovira Cañellas, M. Comabella López, J. Sastre Garriga, M. Tintoré Subirana, X. Montalban Gairín, and G. Arrambide García

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2024
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10. 21417. EFECTIVIDAD DE OCRELIZUMAB EN PACIENTES CON ESCLEROSIS MÚLTIPLE REMITENTE RECURRENTE: ESTUDIO DEL IMPACTO DEL TRATAMIENTO PREVIO

Author

L. Giramé Rizzo, L. Gómez Dabó, R. Carvajal Junco, J. Rio Izquierdo, C. Tur Gomez, G. Arrambide Garcia, A. Cobo Calvo, A. Zabalza de Torres, H. Ariño Rodríguez, P. Tagliani, A. Vilaseca Jolonch, L. Bollo, A. Pappolla, M. Garcia Sarreon, N. Mongay Ochoa, B. Rodríguez Acevedo, J. Castilló Justribó, L. Midaglia Fernández, I. Galán Cartaña, M. Comabella López, C. Auger, A. Rovira Cañellas, J. Sastre Garriga, M. Tintoré Subirana, X. Montalban Gairín, and A. Vidal Jordana

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2024
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12. Serum biomarker levels predict disability progression in patients with primary progressive multiple sclerosis.

Author

Fissolo, Nicolás, Benkert, Pascal, Sastre-Garriga, Jaume, Mongay-Ochoa, Neus, Vilaseca-Jolonch, Andreu, Llufriu, Sara, Blanco, Yolanda, Hegen, Harald, Berek, Klaus, Perez-Miralles, Francisco, Rejdak, Konrad, Villar, Luisa M., Monreal, Enric, Alvarez-Lafuente, Roberto, Soylu, Onder K., Abdelhak, Ahmed, Bachhuber, Franziska, Tumani, Hayrettin, Martínez-Yélamos, Sergio, and Sánchez-López, Antonio J.

Subjects
MULTIPLE sclerosis, BIOMARKERS, GLIAL fibrillary acidic protein, INTERMEDIATE filament proteins
Published
2024
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13. Serum biomarker levels predict disability progression in patients with primary progressive multiple sclerosis

Author

Fissolo, Nicolás, primary, Benkert, Pascal, additional, Sastre-Garriga, Jaume, additional, Mongay-Ochoa, Neus, additional, Vilaseca-Jolonch, Andreu, additional, Llufriu, Sara, additional, Blanco, Yolanda, additional, Hegen, Harald, additional, Berek, Klaus, additional, Perez-Miralles, Francisco, additional, Rejdak, Konrad, additional, Villar, Luisa M, additional, Monreal, Enric, additional, Alvarez-Lafuente, Roberto, additional, Soylu, Onder K, additional, Abdelhak, Ahmed, additional, Bachhuber, Franziska, additional, Tumani, Hayrettin, additional, Martínez-Yélamos, Sergio, additional, Sánchez-López, Antonio J, additional, García-Merino, Antonio, additional, Gutiérrez, Lucía, additional, Castillo-Trivino, Tamara, additional, Lycke, Jan, additional, Rosenstein, Igal, additional, Furlan, Roberto, additional, Filippi, Massimo, additional, Téllez, Nieves, additional, Ramió-Torrentà, Lluís, additional, Lünemann, Jan D, additional, Wiendl, Heinz, additional, Eichau, Sara, additional, Khalil, Michael, additional, Kuhle, Jens, additional, Montalban, Xavier, additional, and Comabella, Manuel, additional

Published
2023
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14. Evaluating the cost-utility of a direct transfer to angiosuite protocol within 6 h of symptom onset in suspected large vessel occlusion patients

Author

Manuel Requena, Valeska Seguel-Ravest, Andreu Vilaseca-Jolonch, Jacklyn Woods, Pablo Guijarro, Marc Ribo, Alejandro Tomasello, Carlos A. Molina, Institut Català de la Salut, [Requena M, Ribo M, Molina CA] Servei de Neurologia, Unitat d’Ictus, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Seguel-Ravest V] Medtronic Ltd, Watford, UK. [Vilaseca-Jolonch A] Servei de Neurologia, Unitat d’Ictus, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Woods J] Medtronic Inc., Minneapolis, MN, USA. [Guijarro P] Medtronic Ibérica SAU, Madrid, Spain. [Tomasello A] Secció de Neuroradiologia Intervencionista, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Budgets, Health Policy, Cost-Benefit Analysis, enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular [ENFERMEDADES], Stroke, Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke [DISEASES], técnicas de investigación::métodos epidemiológicos::estadística como asunto::modelos estadísticos::modelos económicos [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Models, Economic, Health Care Economics and Organizations::Economics::Costs and Cost Analysis::Cost-Benefit Analysis [HEALTH CARE], economía y organizaciones para la atención de la salud::economía::costes y análisis de costes::análisis coste-beneficio [ATENCIÓN DE SALUD], Humans, Cost-eficàcia, Quality-Adjusted Life Years, Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Models, Economic [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Economia de la salut, Malalties cerebrovasculars
Abstract

Catalonia healthcare; Cost-utility; Large vessel occlusion Sanitat de Catalunya; Cost-utilitat; Oclusió de grans vasos Sanidad de Cataluña; Coste-utilidad; Oclusión de grandes vasos Introduction A direct transfer to angiosuite (DTAS) protocol has shown to be effective and safe by shortening in-hospital workflows and encouraging long-term outcome benefits. To implement DTAS at a new facility, a large organizational effort is necessary. We performed a cost-utility analysis and budget impact analysis (BIA) of the operation of a new angiosuite, primarily dedicated to stroke patients, that allows facilities to approximate the cost implications of utilizing a DTAS pathway. Methods Sixty-one patients who underwent endovascular treatment (EVT) following DTAS were matched for baseline variables to 117 patients who underwent a conventional imaging protocol at a hospital in Catalonia, Spain. An economic model, based on actual data from these patients, was developed to assess the short- and long-term clinical and economic implications of DTAS. In the BIA, the DTAS scenario was gradually implemented for 20% of patients each year until reaching a plateau at 80% of patients in the DTAS pathway. Initial investment and additional organizational costs, €4 million, were taken into consideration to compare the budget impact of the DTAS scenario with no organizational changes over five years. Results DTAS was associated with better patient functional independence rates (mRS 0–2: 50.9% vs. 41.0%) and a quality-adjusted life-years gain of 0.82 per patient. Despite the additional initial investment, DTAS development was associated with an estimated 10.2% reduction (€14.7 million) of the total costs (€144.5 million). Cost savings were mainly due to long-term associated costs related to patient disability (€13.2 million). Limitations The study relies on data obtained from a single-center, and therefore it may be difficult to generalize the findings Conclusions Our economic model predicts that the implementation of a DTAS program is cost-effective compared with no organizational changes. Our model also predicts better clinical outcomes for patients in terms of functional independence and quality-adjusted life years. This study was sponsored by Medtronic.

Published
2022

15. 21417. EFECTIVIDAD DE OCRELIZUMAB EN PACIENTES CON ESCLEROSIS MÚLTIPLE REMITENTE RECURRENTE: ESTUDIO DEL IMPACTO DEL TRATAMIENTO PREVIO

Author

Giramé Rizzo, L., Gómez Dabó, L., Carvajal Junco, R., Rio Izquierdo, J., Tur Gomez, C., Arrambide Garcia, G., Cobo Calvo, A., Zabalza de Torres, A., Ariño Rodríguez, H., Tagliani, P., Vilaseca Jolonch, A., Bollo, L., Pappolla, A., Garcia Sarreon, M., Mongay Ochoa, N., Rodríguez Acevedo, B., Castilló Justribó, J., Midaglia Fernández, L., Galán Cartaña, I., Comabella López, M., Auger, C., Rovira Cañellas, A., Sastre Garriga, J., Tintoré Subirana, M., Montalban Gairín, X., and Vidal Jordana, A.

Published
2024
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17. 21092. MEDIR LA CADENA LIGERA DE LOS NEUROFILAMENTOS MEJORA LA CAPACIDAD PREDICTIVA DE LOS SCORES DE RESPUESTA AL TRATAMIENTO EN ESCLEROSIS MÚLTIPLE

Author

Fernández, V., Pappolla, A., Carbonell Mirabent, P., Rodríguez Barranco, M., Castillo Juárez, M., Gutiérrez, L., Fissolo, N., Ariño Rodríguez, H., Auger, C., Bollo, L., Castilló Justribó, J., Cobo Calvo, A., Espejo Ruiz, C., Galán Cartaña, I., Guio Sánchez, C., Lapuma, D., Midaglia Fernández, L., Mongay Ochoa, N., Nos Llopis, C., Otero Romero, S., Rodríguez Acebedo, B., Sastre Garriga, J., Tagliani, P., Tur Gómez, C., Vidal Jordana, A., Vilaseca Jolonch, A., Villacieros Álvarez, J., Zabalza de Torres, A., Rovira Cañellas, A., Tintoré Subirana, M., Comabella López, M., Río Izquierdo, J., Montalban Gairín, X., and Arrambide, G.

Published
2024
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18. 21100. EL VALOR AÑADIDO DE NIVELES ELEVADOS EN SUERO DE LA CADENA LIGERA DE LOS FILAMENTOS PARA PREDECIR ESCLEROSIS MÚLTIPLE AGRESIVA EN SÍNDROMES CLÍNICOS AISLADOS

Author

García Sarreón, M., Reinders, E., Tur Gómez, C., Rodríguez Barranco, M., Fissolo, N., Castillo Juárez, M., Gutiérrez, L., Alberich, M., Carvajal Junco, R., Pappolla, A., Bollo, L., Cobo Calvo, A., Villacieros Álvarez, J., Zabalza de Torres, A., Ariño Rodríguez, H., Tagliani, P., Vilaseca Jolonch, A., Lapuma, D., Vidal Jordana, A., Rodríguez Acebedo, B., Castilló Justribó, J., Galán Cartaña, I., Río Izquierdo, J., Rovira Cañellas, A., Comabella López, M., Sastre Garriga, J., Tintoré Subirana, M., Montalban Gairín, X., and Arrambide García, G.

Published
2024
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19. 21108. MODELADO DEL RIESGO DE INFECCIÓN EN ESCLEROSIS MÚLTIPLE: EVENTOS INICIALES Y RECURRENTES EN UN ESTUDIO DE COHORTE EMPAREJADO BASADO EN POBLACIÓN EN CATALUÑA

Author

Guio Sánchez, C., Cárdenas Robledo, S., Tur Gómez, C., Carbonell Mirabent, P., Carvajal Junco, R., Cobo Calvo, A., Ruiz Camps, I., Albasanz Puig, A., Falcó Roget, A., Romero Herrero, D., Trejo, J., Borras, B., Río Izquierdo, J., Castilló Justribó, J., Mongay Ochoa, N., Vidal Jordana, A., Arrambide García, G., Fernández, V., Rodríguez Acevedo, B., Zalbalza de Torres, A., Midaglia Fernández, L., Bollo ., L., Braga, N., Vilaseca Jolonch, A., Ariño Rodríguez, H., Pappolla, A., Galán Cartaña, I., Comabella López, M., Sastre Garriga, J., Montalban Gairín, X., Tintoré Subirana, M., and Otero Romero, S.

Published
2024
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20. 21436. NEUMONÍA ORGANIZADA SECUNDARIA ASOCIADA A LA INFECCIÓN POR COVID-19 EN PACIENTES CON ENFERMEDADES DESMIELINIZANTES INFLAMATORIAS DEL SISTEMA NERVIOSO CENTRAL TRATADOS CON TERAPIAS ANTI-CD20

Author

Carvajal Junco, R., Rodríguez Acevedo, B., García Vasco, L., Zabalza de Torres, A., Ariño Rodríguez, H., Bollo, L., Cabello Clotet, N., Castilló Justribó, J., Cobo Calvo, A., Comabella López, M., Falco Roget, A., Galán Cartaña, I., García Sarreón, M., Gómez Estévez, I., Granados, G., Lapuma, D., Mato Chain, G., Midaglia Fernández, L., Nieto García, A., Otero Romero, S., Pappolla, A., Rodríguez Barranco, M., Río Izquierdo, J., Tagliani, P., Tur Gómez, C., Vidal Jordana, A., Vilaseca Jolonch, A., Villar, A., Sastre Garriga, J., Oreja Guevara, C., Tintoré Subirana, M., Montalban Gairín, X., and Arrambide García, G.

Published
2024
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21. 21445. INMUNIDAD HUMORAL PREEXISTENTE CONTRA EL SARAMPIÓN Y EL VIRUS DE LA VARICELA-ZÓSTER EN PACIENTES CON ESCLEROSIS MÚLTIPLE TRAS LA EXPOSICIÓN A TERAPIAS ANTI-CD20: ¿SE PIERDE LA PROTECCIÓN?

Author

Carvajal Junco, R., Tur Gómez, C., Carbonell Mirabent, P., Cobo Calvo, A., Ariño Rodríguez, H., Aroca Alsina, M., Arrambide García, G., Bollo, L., Bravo, G., Cárdenas Robledo, S., Castilló Justribó, J., Comabella López, M., Esperalba, J., Galán Cartaña, I., García Sarreón, M., Guio Sánchez, C., Lapuma, D., Midaglia Fernández, L., Pappolla, A., Robles Sánchez, M., Rodríguez Barranco, M., Rodríguez Acevedo, B., Río Izquierdo, J., Tagliani, P., Vidal Jordana, A., Vilaseca Jolonch, A., Zabalza de Torres, A., Sastre Garriga, J., Montalban Gairín, X., Tintoré Subirana, M., and Otero Romero, S.

Published
2024
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22. 21434. SUSPENSIÓN DE TERAPIA ANTI-CD20 EN PACIENTES CON ESCLEROSIS MÚLTIPLE MAYORES DE 55 AÑOS

Author

Carvajal Junco, R., Fadrique, C., Molina, M., Otero Romero, S., Tur Gómez, C., Carbonell Mirabent, P., Cobo Calvo, A., Ariño Rodríguez, H., Arrambide García, G., Bollo, L., Castilló Justribó, J., Comabella López, M., Galán Cartaña, I., García Sarreón, M., Lapuma, D., Marcialis, C., Midaglia Fernández, L., Pappolla, A., Rodríguez Barranco, M., Rodríguez Acevedo, B., Río Izquierdo, J., Tagliani, P., Vidal Jordana, A., Vilaseca Jolonch, A., Zabalza de Torres, A., Sastre Garriga, J., Montalban Gairín, X., and Tintoré Subirana, M.

Published
2024
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24. Evaluating the cost-utility of a direct transfer to angiosuite protocol within 6 hours of symptom onset in suspected large vessel occlusion patients

Author

Requena, Manuel, Seguel, Valeska, Vilaseca-Jolonch, Andreu, Woods, Jacklyn, Guijarro, Pablo, Ribo, Marc, Tomasello, Alejandro, and Molina, Carlos A.

Abstract

A direct transfer to angiosuite (DTAS) protocol has shown to be effective and safe by shortening in-hospital workflows and encouraging long-term outcome benefits. To implement DTAS at a new facility a large organizational effort is necessary. We performed a cost-utility analysis and budget impact analysis (BIA) of the operation of a new angiosuite, primarily dedicated to stroke patients, that allows facilities to approximate the cost implications of utilizing a DTAS pathway. Sixty-one patients who underwent endovascular treatment (EVT) following DTAS were matched for baseline variables to 117 patients who underwent a conventional imaging protocol at a hospital in Catalonia, Spain. An economic model, based on actual data from these patients, was developed to assess the short and long-term clinical and economic implications of DTAS. In the BIA, the DTAS scenario was gradually implemented for 20% of patients each year until reaching a plateau at 80% of patients in the DTAS pathway. Initial investment and additional organizational costs, €four million, were taken into consideration to compare the budget impact of the DTAS scenario with no organizational changes over 5 years. DTAS was associated with better patient functional independence rates (mRS 0-2: 50.9% vs 41.0%) and a quality-adjusted life-years gain of 0.82 per patient. Despite the additional initial investment, DTAS development was associated with an estimated 10.2% reduction (€14.7 million) of the total costs (€144.5 million). Cost savings were mainly due to long-term associated costs related to patient disability (€13.2 million). The study relies on data obtained from a single-center therefore it may be difficult to generalize the findings Our economic model predicts that the implementation of a DTAS program is cost-effective compared to no organizational changes. Our model also predicts better clinical outcomes for patients in terms of functional independence and quality-adjusted life years.

Published
2022
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25. Abstract P134: Economic and Clinical Model for Direct Transfer to Angiosuite Protocol Development

Author

Carlos A. Molina, Marc Ribó, Manuel Requena, Alejandro Tomasello, Andreu Vilaseca-Jolonch, Pablo Guijarro, and Valeska Seguel

Subjects
Advanced and Specialized Nursing, Protocol (science), Workflow, Risk analysis (engineering), business.industry, Medicine, Neurology (clinical), Direct transfer, Cardiology and Cardiovascular Medicine, business, Outcome (game theory), Endovascular therapy
Abstract

Background and purpose: Direct transfer to angiosuite (DTAS) has consistently shown to be effective and safe shortening in-hospital workflows and encouraging long-term outcome benefits. In order to generalize DTAS an organizational and manpower effort is necessary. We aim to perform a cost-effective analysis of the implementation of a new angiosuite primarily dedicated to DTAS of stroke patients that will allow generalization of this pathway Material and methods: Sixty-one patients who underwent endovascular treatment (EVT) following DTAS were matched for baseline variables to 117 patients who underwent conventional imaging protocol before EVT. An economic model based on actual data was developed to assess the short and long term clinical and economic implications. The DTAS development scenario estimates a gradual 20% increase of DTAS rate for 4 years followed by a stable 80% rate of DTAS. Initial investment and additional organizational costs were included: 4M є. A cost-effective study compared the DTAS development scenario (SC1) to a scenario with no organizational changes (SC2) over 10 years. Results: The 10 year model included 1775 EVT patients in each scenario: SC1 60% DTAS Vs SC2 0% DTAS. SC1 would be associated with better functional independence rates (mRS 0-2: 45.8% versus 40.2%; p=0.04) and a quality-adjusted life-years gain of 0.12 per patient. Despite the additional investment, SC1 development was associated with an estimated 15.1% reduction (26.25M є) of total costs (173.749M є). Cost savings was mainly due to long-term associated costs related with patient disability (є 26.4 million). Conclusions: Our economic model predicts that the development of a DTAS program is cost effective.

Published
2021
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27. Tumor-associated status epilepticus: A prospective cohort in a tertiary hospital

Author

Francisco Martínez-Ricarte, Manuel Toledo, Elena Fonseca, Andreu Vilaseca-Jolonch, Esteban Cordero, Manuel Quintana, Laura Abraira, Estevo Santamarina, Vanessa Thonon, María Sueiras, and Javier Salas-Puig

Subjects
Adult, Male, medicine.medical_specialty, Population, Brain tumor, Status epilepticus, Metastasis, Cohort Studies, Tertiary Care Centers, 03 medical and health sciences, Behavioral Neuroscience, Epilepsy, Status Epilepticus, 0302 clinical medicine, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, education, Prospective cohort study, Aged, education.field_of_study, Brain Neoplasms, business.industry, Electroencephalography, Middle Aged, Prognosis, medicine.disease, Hospitalization, Survival Rate, Neurology, Spain, Etiology, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Follow-Up Studies, Brain metastasis
Abstract

Introduction Tumor-associated status epilepticus (TASE) follows a relatively benign course compared with SE in the general population. Little, however, is known about associated prognostic factors. Methods We conducted a prospective, observational study of all cases of TASE treated at a tertiary hospital in Barcelona, Spain between May 2011 and May 2019. We collected data on tumor and SE characteristics and baseline functional status and analyzed associations with outcomes at discharge and 1-year follow-up. Results Eighty-two patients were studied; 58.5% (n = 48) had an aggressive tumor (glioblastoma or brain metastasis). Fifty-one patients (62.2%) had a favorable outcome at discharge compared with just 30 patients (25.8%) at 1-year follow-up. Fourteen patients (17.1%) died during hospitalization. Lateralized period discharges (LPDs) on the baseline electroencephalography (EEG), presence of metastasis, and SE severity were significantly associated with a worse outcome at discharge. The independent predictors of poor prognosis at 1-year follow-up were SE duration of at least 21 h, an aggressive brain tumor, and a nonsurgical treatment before SE onset. Lateralized period discharges, super-refractory SE, and an aggressive tumor type were independently associated with increased mortality. Conclusions Status epilepticus duration is the main modifiable factor associated with poor prognosis at 1-year follow-up. Accordingly, patients with TASE, like those with SE of any etiology, should receive early, aggressive treatment.

Published
2020
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