[Hospital mortality at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (1995-2001)]. / Mortalidad hospitalaria en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" (1995-2001).

UNLABELLED: To improve health policies directed toward ameliorating quality and also to characterize the profile of patients who attend medical centers, it is necessary to determine causes of mortality in any healthcare organization. OBJECTIVE: To analyze time-trend hospital mortality at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (MVS-NINN) between 1995 and 2001. METHODS: Data were taken from database of morbidity, and mortality of MVS-NINN. All cases were coded by the International Classification of Disease (10th edition). We calculated specific rates of mortality and time-trends during a 7-year-period. RESULTS: When main causes of mortality were included in these analyzes, rates of hospital mortality at MVS-NINN showed a non-significant tendency to decrease during this period. CONCLUSIONS: Decline of mortality time-trend is generally in accordance with increasing life expectancy of Mexican population; this increase is due to progress in medical knowledge and to new technological and therapeutic advances, especially in the third level institutions such as this institute.

Mortalidad hospitalaria en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" (1995-2001) / Hospital Mortality at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (1995-2001)

Determinar las causas de muerte en cualquier institución de salud contribuye a la toma de decisiones encaminadas a mejorar los servicios de salud, así como para conocer el perfil de la población que acude a recibir atención médica. Objetivo: analizar la mortalidad hospitalaria y su tendencia durante el periodo de 1995-2001 en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" (INNN-MVS). Material y métodos: se utilizó la base de datos con la que cuenta el Departamento de Epidemiología del INNN-MVS, que se encuentra codificada de acuerdo a la Clasificación Internacional de Enfermedades décima versión (CIÉ-10). Se calcularon las diferentes tasas de mortalidad y se determinó su tendencia a través del período de siete años. Resultados: las principales causas de mortalidad durante el periodo de estudio fueron las hemorragias intraencefálicas y las subaracnoideas. En general se encontró una tendencia a la disminución en las principales causas de mortalidad. Conclusiones: la tendencia a la disminución concuerda con el incremento en la esperanza de vida de nuestra población, situación que se ha presentado por el progreso en los conocimientos médicos y a las nuevas técnicas diagnósticas y terapéuticas con las que cuenta una institución de tercer nivel de salud, como lo es el INNN-MVS.

To improve health policies directed toward ameliorating quality and also to characterize the profile of patients who attend medical centers, it is necessary to determine causes of mortality in any healthcare organization. Objective: To analyze time-trend hospital mortality at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (MVS-NINN) between 1995 and 2001. Methods: Data were taken from database of morbidity and mortality of MVS-NINN. All cases were coded by the International Classification of Disease (10th edition). We calculated specific rates of mortality and time-trends during a 7-year-period. Results: When main causes of mortality were included in these analyzes, rates of hospital mortality at MVS-NINN showed a non-significant tendency to decrease during this period. Conclusions: Decline of mortality time-trend is generally in accordance with increasing life expectancy of Mexican population; this increase is due to progress in medical knowledge and to new technological and therapeutic advances, especially in the third level institutions such as this institute.

[Morbility at the Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, 1995-2001]. / Morbilidad en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" 1995-2001.

UNLABELLED: Hospital statistics are very important as tools that help to define research objectives and design health programs. OBJECTIVE: To determine the main causes of hospital morbility at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (MVS-NINN) between 1995 and 2001. MATERIAL AND METHODS: Data were taken from the electronic database of morbidity and mortality of MVS-NINN. All outpatient records between 1995 and 2001 were considered. We calculated trends and specific rates of morbidity per 100 discharged patients. RESULTS: The main causes of morbility were brain tumors, schizophrenic illness, neurocysticercosis, and stroke. We found a statistically significant declining time-trend of schizophrenic illness and in non-traumatic brain hemorrhage in males. In the case of females, we observed an increasing time-trend of benign meningeal tumors. The age groups more affected in both genders were those < 51 years of age. CONCLUSIONS: This study is not a population study, but it helps to increase knowledge of the main causes of hospitalization at one of the most important neurologic institutions in the world, which provides care for thinsured population throughout Mexico. These findings facilitate analysis and decision-making to undertake specifications to improve the quality of neurologic medical attention.

Morbilidad en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" 1995-2001

La estadística hospitalaria es una herramienta que brinda apoyo a directivos, residentes e investigadores para conocer la demanda de atención médica en cada hospital o Instituto de Salud. Objetivo: identificar las principales causas de morbilidad hospitalaria del Instituto Nacional de Neurología Neurocirugía Manuel Velasco Suárez (INNN-MVS) ocurridas en el período 1995-2001. Material y métodos: análisis retrospectivo de egresos ocurridos de 1995 a 2001 de la base de datos de morbilidad y mortalidad del INNN-MVS; se calcularon tasas específicas de morbilidad por 100 egresos y tendencias. Resultados: las principales causas de morbilidad fueron tumores cerebrales, esquizofrenia, neurocisticercosis y evento vascular cerebral. Se encontró una tendencia hacia la disminución con los años estadísticamente significativa en esquizofrenia y hemorragias intracraneales no traumáticas en el sexo masculino y para el sexo femenino, una tendencia hacia el aumento en tumores benignos de las meninges. Los grupos de edad más atendidos por las principales causas de morbilidad fueron los menores de 51 años. Conclusiones: el presente no es un estudio poblacional, pero permite acercarnos a conocer las principales demandas de atención de uno de los Institutos neurológicos más grandes del mundo, que atiende a población abierta y derechohabiente de todo el país. Esto contribuye a clarificar el panorama para determinar necesidades de atención médica neurológica.

Hospital statistics are very important as tools that help to define research objectives and design health programs. Objective: to determine the main causes of hospital morbility at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (MVS-NINN) between 1995 and 2001. Material and Methods: data were taken from the electronic database of morbidity and mortality of MVS-NINN. All out-patient records between 1995 and 2001 were considered. We calculated trends and specific rates of morbidity per 100 discharged patients. Results: the main causes of morbility were brain tumors, schizophrenic illness, neurocysticercosis, and stroke. We found a statistically significant declining time-trend of schizophrenic illness and in non-traumatic brain hemorrhage in males. In the case of females, we observed an increasing time-trend of benign meningeal tumors. The age groups more affected in both genders were those < 51 years of age. Conclusions: This study is not a population study, but it helps to increase knowledge of the main causes of hospitalization at one of the most important neurologic institutions in the world, which provides care for thinsured population throughout Mexico. These findings facilitate analysis and decision-making to undertake specificactions to improve the quality of neurologic medical attention.

Clinical-histopathologic concordance of tumors of the nervous system at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery in Mexico City.

CONTEXT: When making a diagnosis, the main purpose of clinicians should not be to achieve certainty, but to decrease diagnostic uncertainty in order to make optimal therapeutic decisions. Diagnostic concordance is an essential characteristic if a measurement is to be considered scientific. In the case of tumors of the nervous system (TNS), one of the most accurate diagnostic tests is magnetic resonance imaging. However, histopathologic analyses are essential, because they refine the diagnosis, benefit the patient, and improve our understanding of the disease. By determining the clinical-histopathologic correlation of TNS in one of the main neurologic centers in Mexico, we sought to project reliable morbidity and/or mortality statistics. OBJECTIVE: To assess clinical and histopathologic diagnostic agreement in cases involving TNS admitted to the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery between 1990 and 1999. DESIGN: Cross-sectional diagnostic concordance study, including all clinical hospital records of patients with histopathologically diagnosed TNS, classified according to World Health Organization criteria. RESULTS: Among 2041 TNS cases, the 3 most frequent types were those affecting the neuroepithelial tissue (32.9%), tumors of the sellar region (29.2%), and tumors of the meninges (25.6%). We found that, overall, clinical-histopathologic concordance for these 3 categories was substantial and statistically significant. CONCLUSIONS: Tumors of the nervous system constitute a heterogeneous group of neoplasms. In the present study, clinical diagnoses substantially agreed with pathologic diagnoses. The a priori clinical diagnosis allowed prompt treatment even before diagnostic confirmation by histopathologic analysis, which is the best way to confirm, clarify, and correct a diagnosis.