title: Use of healthcare resources and costs of acute cardioembolic stroke management in the Region of Madrid: The CODICE Study.
abstract: BACKGROUND
  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.
authors: Pharmacoeconomics and Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Madrid, España. Electronic address: fdeandres@porib.com.
authors: F
authors: F
authors: de Andrés-Nogales
authors: Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, España.
authors: J
authors: J
authors: Vivancos Mora
authors: Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
authors: F J
authors: FJ
authors: Barriga Hernández
authors: Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: F
authors: F
authors: Díaz Otero
authors: Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors: L
authors: L
authors: Izquierdo Esteban
authors: Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
authors: M Á
authors: MÁ
authors: Ortega-Casarrubios
authors: Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
authors: L
authors: L
authors: Castillo Moreno
authors: Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, España.
authors: Á
authors: Á
authors: Ximénez-Carrillo Rico
authors: Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: M P
authors: MP
authors: Martín Torres
authors: Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors: C I
authors: CI
authors: Gómez-Escalonilla Escobar
authors: Pharmacoeconomics and Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Madrid, España.
authors: C
authors: C
authors: Torres González
authors: Departamento de Investigación de Resultados en Salud y Farmacoeconomía, Pfizer S. L. U., Alcobendas, Madrid, España.
authors: M
authors: M
authors: de Salas-Cansado
authors: Pharmacoeconomics and Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Madrid, España.
authors: M Á
authors: MÁ
authors: Casado Gómez
authors: Departamento de Investigación de Resultados en Salud y Farmacoeconomía, Pfizer S. L. U., Alcobendas, Madrid, España.
authors: J
authors: J
authors: Soto Álvarez
authors: Hospital General Universitario Gregorio Marañón, Madrid, España.
authors: A
authors: A
authors: Gil-Núñez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D004617:Embolism / Q000150:complications* / Q000628:therapy; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000628:therapy; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012046:Rehabilitation / Q000191:economics; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000191:economics* / Q000209:etiology / Q000628:therapy*
keywords: Cardioembolic stroke; Comunidad de Madrid; Costes; Costs; Ictus; Infarto cerebral cardioembólico; Region of Madrid (Spain); Resource use; Sanidad Pública; Spanish National Health System; Stroke; Utilización de recursos