Introduction: Traumatic brain injury (TBI) is a leading cause of morbidity worldwide, with the Glasgow Coma Scale (GCS) serving as a tool to measure injury severity. This study aimed to investigate the relationship between GCS admission scores and various socio-demographic, clinical, injury-related, and hospital-related variables in patients with TBI across two tertiary care centers in Eastern Europe, a region that remains underrepresented in the literature. Methods: A retrospective observational study was conducted using data from 119 TBI patients admitted between March 2020 and June 2023 at Cluj County Emergency Hospital (Romania) and Saint Vincent Hospital (Poland). GCS scores were analyzed as both categorical and continuous variables. Statistical analyses included Wilcoxon and Kruskal–Wallis tests for group comparisons and Spearman correlations for continuous variables. Results: Most patients included suffered a mild TBI (GCS score between 13 and 15). There were significant associations between GCS scores and post-traumatic amnesia (p < 0.05), discharge status (p < 0.01), discharge destination (p < 0.01), and education level (p < 0.01). GCS scores at admission were linked to survival, absence of post-traumatic amnesia, higher education levels, and home discharge. No significant differences observed across sex, residence, employment status, injury type, cause, or mechanism of injury. A weak but significant negative correlation was observed between GCS and length of hospital stay (rho = −0.229, p > 0.05), while age showed a non-significant correlation. Conclusions: The GCS score at admission is significantly associated with various clinical and socio-demographic outcomes in TBI patients, supporting the utility of the GCS score as a prognostic tool. The predominance of mild cases and the absence of radiological data, such as cerebral contusions or epidural or subdural hematomas, limit the generalizability of the findings. Further studies with larger samples and comprehensive imaging data are necessary to validate these findings.

The cost-effectiveness of Cerebrolysin as an add-on therapy for moderate–severe acute ischemic stroke is a topic that remains understudied. This study aims to address this gap by performing a comprehensive cost-utility analysis using both deterministic and probabilistic methods from a payer perspective and within the Romanian inpatient care setting. Quality-adjusted life years (QALYs) were calculated using partial individual patient data from the 2016 Cerebrolysin and Recovery After Stroke (CARS) trial, utilizing three different health state valuation models. Cost data was extracted from actual acute care costs reported by Romanian public hospitals for reimbursement purposes for patients included in the CARS study. Incremental cost-effectiveness ratios were calculated for each treatment arm for the duration of the clinical trial. Deterministic analysis based on sample mean values indicates Cerebrolysin would be cost-effective at a threshold between roughly 18.8 and 29.9 thousand EUR, depending on valuation techniques. Probabilistic sensitivity analysis results indicate an 80% chance probability of cost-effectiveness of Cerebrolysin as an add-on therapy for acute ischemic stroke, considering a willingness-to-pay threshold of 50,000 EUR in a 90-day timeframe after stroke. Further economic evaluations of Cerebrolysin are needed to strengthen these findings, covering a timeframe of at least 12 months after the acute incident, which would account for treatment effects spanning beyond the first 90 days after ischemic stroke. These should be conducted to determine its cost-effectiveness under various care settings and patient pathways. Most importantly, modelling techniques are needed to answer important questions such as the estimates of population gain in QALYs after acute administration of Cerebrolysin and the potential offsetting of direct medical costs as a result of administering the intervention.

Introduction: Traumatic brain injury (TBI) is a significant global public health issue, with long-term impacts on patients. This study examines the relationship between TBI severity, as measured by the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) at admission, and various sociodemographic, clinical, and injury-related factors. Methods: We conducted a retrospective analysis using data from 164 adult TBI patients. All were admitted between March 2020 and June 2023 to two Eastern European tertiary hospitals. Variables included sex, age, education, employment, marital status, injury type and cause, place of injury, and clinical measures such as the Marshall score, AIS, and ISS. Statistical methods included Pearson’s Chi-squared, Fisher’s exact, Spearman correlation, Wilcoxon, and Kruskal–Wallis tests. Results: Most patients were male (65.9%), retired (59.8%), and urban residents (73.8%), with a mean age of 64.98 years. The most frequent mechanism of injury was falls (76.2%), typically occurring at home (61%). The predominant injury type was closed head trauma (93.3%). Most patients had mild AIS scores (75%), and the mean ISS was 6.52 (SD: 4.55). Statistically significant group differences were found for AIS among categories of Modified Marshall Score, injury type, and education categories and for ISS among categories of the Modified Marshall Score, injury type, cause and place of injury, employment status, and sex. No significant correlations were found between AIS or ISS and age or hospital length of stay. Conclusions: AIS is more anatomically focused. ISS reflects broader systemic injury patterns and is more influenced by contextual factors. These findings are particularly relevant for the Eastern European population and can help develop better healthcare policies for the region.

Background: Alopecia areata is a skin disease that affects patients’ quality of life and social participation and it exerts an economic burden of patients and implicitly their family. To date, this is the first study to quantify the economic burden of alopecia areata for both pediatric and adult patients. Objective: This cost of illness study seeks to quantify the economic burden of alopecia areata for patients aged <20 years and 20+ years for both mild and severe forms of alopecia areata using retrospective and prospective data sources, both incidence and prevalence-based approaches. This cost of illness study is mixed as it employs both top-down and bottom-up approaches. Results: The results of this cost of illness study show that for adults, for both prevalence and incidence-based approach, the highest costs are the direct costs attributable to medical services and associated costs, and the indirect costs due to work absenteeism. Regarding the pediatric population segment, the highest costs were due to treatment, associated expenses and productivity costs inquired by caregivers. Conclusion: This is the first study to quantify the burden of alopecia areata in Romania, for both pediatric and adult patients. Our study highlights that out-of-pocket costs pose an immense burden on patients and their caregivers. Our estimations emphasize that patients with AA should be considered when planning health services delivery and health services and medicine reimbursement.

Traumatic brain injuries (TBIs) are a leading cause of death and long-term disability worldwide, with incidence and injury mechanisms varying by age group

Introduction: Atopic dermatitis (AD), a common dermatological condition, is often associated with significant economic and social burdens. Despite extensive studies globally, there is a gap in understanding the impact of this condition in Romania. This study evaluated the economic burden of AD in Romania, considering both direct and indirect costs. Materials and methods: A cost of illness study, conducted from a broad perspective, considering 2022 as a reference, using top-down and bottom-up approaches and retrospective and prospective data sources was used to assess direct medical costs (treatments, medical services, hospitalizations), direct non-medical costs (associated costs due to transportation, accommodation), and indirect costs (productivity losses) across four costing scenarios. Results: In 2022, the total cost of atopic dermatitis in Romania was €29,810,077.2 for adult patients and €133,635,535.2 for pediatric patients, based on a prevalence-based approach, and €5,529,867.8 for adults and €53,175,049.1 for pediatric AD patients when using an incidence-based approach. Medical costs had the highest attributable share of the AD cost for adult patients while productivity costs (inquired by caregivers) had the highest share for pediatric AD patients in both approaches. T he overall average annual cost per patient ranged, depending on the scenarios, between €284.72 and €1,045 for adult AD patients and between €293.73 and €9,558.52 for pediatric AD patients. Discussion: Our results show the increased burden among pediatric AD patients emphasizing the need that future policy interventions should be tailored according the patients’ age.