Background/Objectives: Wernicke encephalopathy (WE) is an acute neurological syndrome caused by severe thiamine deficiency. Early detection is challenging due to the low sensitivity of the classic triad. Methods: This retrospective observational study used the Spanish Minimum Basic Data Set, including hospital admissions with a primary diagnosis of WE (2016–2022). Demographic, clinical, and economic variables were also analyzed. Severity of illness (SOI) and risk of mortality (ROM) were assessed using the All Patient Refined Diagnosis-Related Groups (APR–DRG) system. Results: A total of 2477 WE episodes were included (1864 men; mean age, 58.2 years; standard deviation [SD], 11.0). The hospital admission rate increased by an average of 16% per year (incidence rate ratio [IRR], 1.16; p < 0.001). The proportion of foreign-born patients increased significantly over the study period. Most patients were discharged home (1868; 75.4%), whereas transfers to residential care facilities increased over time. The mean hospital stay was 19.0 days (SD 36.5). In-hospital mortality was 3.7%. In multivariable analysis, malnutrition (odds ratio [OR] 1.64), cancer (OR 2.11), and active infection (OR 5.79) were independently associated with mortality. The incorporation of ROM into the mortality model markedly improved discrimination, and mortality increased progressively with higher ROM categories: moderate (OR 3.45), major (OR 11.76), and extreme (OR 38.76) (all p < 0.001). Conclusions: WE is an increasingly frequent cause of neurological hospitalization in Spain, associated with a substantial clinical and economic burden. In-hospital mortality is driven mainly by overall clinical complexity and comorbidity burden rather than by WE in isolation.

Objective: SLE is a complex autoimmune disease that causes significant health issues. In this study, SLE-related healthcare episodes, in-hospital mortality and resource use in Spain from 2016 to 2022 were assessed. Methods: In this retrospective, nationwide, repeated cross-sectional study, International Classification of Diseases, 10th Revision, data from Spain’s National Hospital Discharge Registry were used to identify healthcare episodes with SLE (or its subtypes) coded as the principal diagnosis. Temporal trends were analysed and group comparisons were made using χ², Fisher’s exact test, Student’s t test and Mantel-Haenszel trend test. Results: A total of 24 151 SLE episodes were identified, with the majority occurring in women (86.9%) and individuals aged 15–65 years (88.2%). SLE episodes increased from 3002 (6.5/100 000 population) in 2016 to 4226 (8.8/100 000 population) in 2022 (p<0.001). Lupus nephritis episodes rose from 525 (1.13/100 000 population) to 956 (2.0/100 000 population; p<0.001). Relative to all other hospitalisation episodes, SLE episodes had longer hospital stays (8.7 vs 7.1 days; p<0.001) and intensive care unit (ICU) stays (8.4 vs 4.9 days; p=0.031). In-hospital mortality was low and stable. In unadjusted comparisons, mortality was lower among SLE episodes than among other hospitalisation episodes (0.3% vs 1.2%; p<0.001). A larger proportion of in-hospital deaths during SLE episodes than during all other hospitalisation episodes occurred in individuals aged 15–65 years (42.5% vs 15.1%; p<0.001). Although more deaths occurred in women, mortality was higher among men in unadjusted comparisons (0.7% vs 0.3%; p<0.001). Conclusions: SLE-related healthcare episodes increased in Spain from 2016 to 2022, but in-hospital mortality remained stable. SLE episodes involved longer hospital and ICU stays than other episodes. These results reflect healthcare utilisation patterns, not disease severity or patient outcomes.

Mujer de 80 años con enfermedad renal crónica de estadio 5 secundaria a poliquistosis renal autosómica dominante, y en diálisis peritoneal automatizada, que desarrolló calcifilaxis cutánea, una complicación infrecuente y alta morbimortalidad en pacientes en tratamiento renal sustitutivo. Ingresó con dolor y celulitis en la pierna derecha, evolucionando a úlcera dolorosa. Se confirmó calcifilaxis mediante biopsia cutánea. Se optó por una combinación de tratamiento renal sustitutivo, manteniendo la diálisis peritoneal e intensificando de forma transitoria la hemodiálisis para optimizar el control metabólico y la administración de tiosulfato sódico intravenoso. El abordaje multidisciplinar, Medicina Interna, Nefrología y Dermatología, fue decisivo en el control del metabolismo calcio-fósforo, el control analgésico, prevenir infecciones y el restablecimiento de las lesiones cutáneas. La mejoría clínica tras intensificación de la diálisis y terapia con tiosulfato sódico permitió reducir escalonadamente la intensidad de la hemodiálisis, manteniendo la diálisis peritoneal como técnica principal. Este caso pone de relieve la importancia de un manejo individualizado y multidisciplinar de la calcifilaxis y sugiere que, en pacientes seleccionados, la combinación temporal de técnicas de tratamiento renal sustitutivo es eficaz optimizando el control metabólico y preservando la calidad de vida. La paciente ingresó con dolor y celulitis en la pierna derecha, evolucionando a una úlcera dolorosa. Tras la confirmación de calcifilaxis mediante biopsia, el tratamiento incluyó hemodiálisis intensificada y administración de tiosulfato sódico intravenoso. A pesar de algunas complicaciones iniciales, como náuseas y vómitos, se ajustó la premedicación, logrando tolerancia al tratamiento. El manejo multidisciplinar fue crucial, permitiendo mejorar el control del metabolismo calcio-fósforo y la evolución de las lesiones cutáneas. La terapia con tiosulfato sódico resultó efectiva, reduciendo la necesidad de hemodiálisis y estabilizando a la paciente. En resumen, este caso subraya la importancia del tratamiento con tiosulfato sódico y la colaboración entre especialidades para abordar las complicaciones de la calcifilaxia, mejorando significativamente la calidad de vida de la paciente.

Objectives: To determine the incidence, predictors and impact of pneumonia among hospitalized patients with ANCA-associated vasculitis (AAV). Methods: A nationwide retrospective analysis of Spanish hospital discharges (2016–2023) identified all AAV admissions and coexisting pneumonia using ICD-10 codes. Outcomes included pneumonia incidence, intensive care unit (ICU) utilization, length of stay, temporal trends, in-hospital mortality and case fatality rate (CFR). Illness severity was classified using the severity of illness (SOI) and risk of mortality (ROM) indices. Multivariable logistic regression was used to identify independent predictors of in-hospital mortality. Results: Among 12 378 AAV hospitalizations, 1280 (10.3%) had pneumonia. Pneumonia was associated with higher ICU admission rates (13.5% vs 6.5%), longer stays (median 22 vs 17 days), and greater in-hospital mortality (14.9% vs 4.4%) than those without pneumonia (all P < 0.001). In-hospital AAV mortality increased significantly over time (incidence rate ratio [IRR], 1.13 per year; P < 0.001). Viral pneumonia cases in AAV surged during the COVID-19 pandemic (2021–2022), declined by 2023, and showed a significant overall increase across the study period (IRR, 1.46; 95% CI: 1.38, 1.54; P < 0.001). In-hospital CFR rose sharply with extreme SOI (27.1% vs 18.7%; P < 0.001). Pneumonia was an independent predictor of death (odds ratio 1.97; 95% CI: 1.63, 2.37; P < 0.001), and a higher ROM was strongly associated with mortality risk. Conclusion: Around 1 in 10 hospitalizations with AAV develop pneumonia, which is associated with higher odds of in-hospital death and greater ICU utilization. Pneumonia is strongly associated with worse outcomes in AAV, supporting the need for proactive infection prevention and early treatment in AAV.