Epidemiology, Comorbidities, and Outcomes of Posterior Reversible Encephalopathy Syndrome in Children in the United States.

Affiliation

Department of Pediatrics, Metro Health Medical Center - Case Western Reserve University, Cleveland, Ohio. Electronic address: [Email]

Abstract

BACKGROUND : Posterior reversible encephalopathy syndrome is an increasingly recognized entity with certain identified predisposing factors in children. However, the actual incidence, comorbidities, outcomes, and hospitalization charges among children (aged < 20 years) in the United States are largely unknown.
METHODS : We analyzed the Kids' Inpatient Database for incidence of posterior reversible encephalopathy syndrome-related hospitalizations, associated diagnoses, in-hospital outcomes, and charges for children in the United States in 2016. We report demographics, risk factors, discharge status, mortality, length of stay, and hospitalization charges.
RESULTS : In 2016, 825 pediatric hospitalizations related to posterior reversible encephalopathy syndrome were captured in the Kids' Inpatient Database. Hospital discharges including solid organ transplant, bone marrow transplant, hypertension, renal disorder, primary immunodeficiency, malignancy, sepsis, severe sepsis, systemic connective tissue disorder, blood transfusion, hypomagnesemia, and sickle cell anemia were queried for presence of posterior reversible encephalopathy syndrome. The majority of patients were discharged home. We found that posterior reversible encephalopathy syndrome-related hospitalizations were significantly associated with increased length of stay and hospitalization charges in 2016 (P < 0.001). A mortality rate of 3.2% was found in posterior reversible encephalopathy syndrome-related hospitalizations when compared with 0.4% in non-posterior reversible encephalopathy syndrome hospitalizations (P < 0.001).
CONCLUSIONS : Incidence of posterior reversible encephalopathy syndrome-related hospitalizations is 0.04%. Hypertension and presence of renal disorder are the most significant risk factors found to be associated with posterior reversible encephalopathy syndrome. Presence of posterior reversible encephalopathy syndrome was associated with a significant increase in hospitalization charges and increased length of stay.

Keywords

Incidence,Kids Inpatient Database,Outcomes,PRES,Posterior reversible encephalopathy syndrome,Vasogenic edema,

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