What can be expected to be seen in a Neurology ward? Eleven-year experience in a Brazilian university hospital

Abstract

Background: Neurological disorders are significant causes of morbidity and mortality worldwide. However, data about general neurological inpatient admissions in Brazil is limited. Objective: To investigate the prevalence of neurological disorders according to disease group and lesion site among patients admitted to a general Neurology ward. Methods: This was an observational and descriptive study. The hospital discharge database for the Neurology ward was surveyed in accordance with the International Classification of Diseases, 10th edition (ICD-10), from September 2008 to October 2019. The final diagnosis was classified into neurological disorder groups and site. Results: Overall, 2,606 clinical neurological patient files were included, with mean length of hospitalization of 16.7 days and a total of 325 readmissions (12.5%). The overall mortality rate in the ward was 3.8% (100 patients). Among all the diagnoses, cerebrovascular disease was the most prevalent (45.8%), followed by inflammatory disorders (22.2%). The brain was the most common lesion site (66.0%), followed by peripheral nerves (10.0%) and meninges and cerebrospinal fluid (7.7%). Conclusions: The disease pattern upon admission showed that a majority of the cases consisted of cerebrovascular disorders and that the brain was the most frequently affected structure, although we observed that a wide variety of cases were admitted, encompassing all neurological disorders.

Psychiatric Comorbidities in Neurologic Hospitalizations in Portugal: A Nationwide Retrospective Observational Study

“…Neurological disorders account for nearly 12% of the total number of deaths worldwide and are the leading cause of overall disease burden, represented by the number of years of healthy life lost due to disability. 1 Psychiatric co-morbidities, such as major depression, neurocognitive disorder, anxiety, substance use, and schizophrenia-spectrum disorders, are frequent among general medical inpatients, with prevalence rates ranging from 12% to 53%. [1][2][3][4][5][6][7][8][9] Psychiatric illness is common among patients with neurological conditions and is often unrecognized.…”

“…1 Psychiatric co-morbidities, such as major depression, neurocognitive disorder, anxiety, substance use, and schizophrenia-spectrum disorders, are frequent among general medical inpatients, with prevalence rates ranging from 12% to 53%. [1][2][3][4][5][6][7][8][9] Psychiatric illness is common among patients with neurological conditions and is often unrecognized. 1,2,9,10 Up to 50% of patients with neurological disorders develop depression.…”

“…[1][2][3][4][5][6][7][8][9] Psychiatric illness is common among patients with neurological conditions and is often unrecognized. 1,2,9,10 Up to 50% of patients with neurological disorders develop depression. 1,[9][10][11][12] Anxiety and adjustment disorders have been commonly described in patients with a diagnosis of migraine.…”

“…1,2,9,10 Up to 50% of patients with neurological disorders develop depression. 1,[9][10][11][12] Anxiety and adjustment disorders have been commonly described in patients with a diagnosis of migraine. 1,12 Functional neurological symptoms are common; it was reported that 14% of consecutive neurological admissions had no 'organic' basis for their symptoms, while 24% had symptoms not fully explained by the underlying condition.…”

“…1,[9][10][11][12] Anxiety and adjustment disorders have been commonly described in patients with a diagnosis of migraine. 1,12 Functional neurological symptoms are common; it was reported that 14% of consecutive neurological admissions had no 'organic' basis for their symptoms, while 24% had symptoms not fully explained by the underlying condition. 1,9 Moreover, drugs used in the treatment of neurological diseases may induce psychiatric manifestations.…”