Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.

<h4>Background</h4>Encephalitis rates by etiology and acute-phase outcomes for encephalitis in the 21st century are largely unknown. We sought to evaluate cause-specific rates of encephalitis hospitalizations and predictors of inpatient mortality in the United States.<h4>Methods<...

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Autores principales:	Benjamin P George, Eric B Schneider, Arun Venkatesan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bd77d7c6cbf54d1497e4a98cf320a3bc
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spelling	oai:doaj.org-article:bd77d7c6cbf54d1497e4a98cf320a3bc2021-11-25T06:01:40ZEncephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.1932-620310.1371/journal.pone.0104169https://doaj.org/article/bd77d7c6cbf54d1497e4a98cf320a3bc2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25192177/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Encephalitis rates by etiology and acute-phase outcomes for encephalitis in the 21st century are largely unknown. We sought to evaluate cause-specific rates of encephalitis hospitalizations and predictors of inpatient mortality in the United States.<h4>Methods</h4>Using the Nationwide Inpatient Sample (NIS) from 2000 to 2010, a retrospective observational study of 238,567 patients (mean [SD] age, 44.8 [24.0] years) hospitalized within non-federal, acute care hospitals in the U.S. with a diagnosis of encephalitis was conducted. Hospitalization rates were calculated using population-level estimates of disease from the NIS and population estimates from the United States Census Bureau. Adjusted odds of mortality were calculated for patients included in the study.<h4>Results</h4>In the U.S. from 2000-2010, there were 7.3±0.2 encephalitis hospitalizations per 100,000 population (95% CI: 7.1-7.6). Encephalitis hospitalization rates were highest among females (7.6±0.2 per 100,000) and those <1 year and >65 years of age with rates of 13.5±0.9 and 14.1±0.4 per 100,000, respectively. Etiology was unknown for approximately 50% of cases. Among patients with identified etiology, viral causes were most common (48.2%), followed by Other Specified causes (32.5%), which included predominantly autoimmune conditions. The most common infectious agents were herpes simplex virus, toxoplasma, and West Nile virus. Comorbid HIV infection was present in 7.7% of hospitalizations. Average length of stay was 11.2 days with mortality of 5.6%. In regression analysis, patients with comorbid HIV/AIDS or cancer had increased odds of mortality (odds ratio [OR] = 1.70; 95% CI: 1.30-2.22 and OR = 2.26; 95% CI: 1.88-2.71, respectively). Enteroviral, postinfectious, toxic, and Other Specified causes were associated with lower odds vs. herpes simplex encephalitis.<h4>Conclusions</h4>While encephalitis and encephalitis-related mortality impose a considerable burden in the U.S. in the 21st Century, the reported demographics of hospitalized encephalitis patients may be changing.Benjamin P GeorgeEric B SchneiderArun VenkatesanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 9, p e104169 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Benjamin P George Eric B Schneider Arun Venkatesan Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.
description	<h4>Background</h4>Encephalitis rates by etiology and acute-phase outcomes for encephalitis in the 21st century are largely unknown. We sought to evaluate cause-specific rates of encephalitis hospitalizations and predictors of inpatient mortality in the United States.<h4>Methods</h4>Using the Nationwide Inpatient Sample (NIS) from 2000 to 2010, a retrospective observational study of 238,567 patients (mean [SD] age, 44.8 [24.0] years) hospitalized within non-federal, acute care hospitals in the U.S. with a diagnosis of encephalitis was conducted. Hospitalization rates were calculated using population-level estimates of disease from the NIS and population estimates from the United States Census Bureau. Adjusted odds of mortality were calculated for patients included in the study.<h4>Results</h4>In the U.S. from 2000-2010, there were 7.3±0.2 encephalitis hospitalizations per 100,000 population (95% CI: 7.1-7.6). Encephalitis hospitalization rates were highest among females (7.6±0.2 per 100,000) and those <1 year and >65 years of age with rates of 13.5±0.9 and 14.1±0.4 per 100,000, respectively. Etiology was unknown for approximately 50% of cases. Among patients with identified etiology, viral causes were most common (48.2%), followed by Other Specified causes (32.5%), which included predominantly autoimmune conditions. The most common infectious agents were herpes simplex virus, toxoplasma, and West Nile virus. Comorbid HIV infection was present in 7.7% of hospitalizations. Average length of stay was 11.2 days with mortality of 5.6%. In regression analysis, patients with comorbid HIV/AIDS or cancer had increased odds of mortality (odds ratio [OR] = 1.70; 95% CI: 1.30-2.22 and OR = 2.26; 95% CI: 1.88-2.71, respectively). Enteroviral, postinfectious, toxic, and Other Specified causes were associated with lower odds vs. herpes simplex encephalitis.<h4>Conclusions</h4>While encephalitis and encephalitis-related mortality impose a considerable burden in the U.S. in the 21st Century, the reported demographics of hospitalized encephalitis patients may be changing.
format	article
author	Benjamin P George Eric B Schneider Arun Venkatesan
author_facet	Benjamin P George Eric B Schneider Arun Venkatesan
author_sort	Benjamin P George
title	Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.
title_short	Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.
title_full	Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.
title_fullStr	Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.
title_full_unstemmed	Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.
title_sort	encephalitis hospitalization rates and inpatient mortality in the united states, 2000-2010.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/bd77d7c6cbf54d1497e4a98cf320a3bc
work_keys_str_mv	AT benjaminpgeorge encephalitishospitalizationratesandinpatientmortalityintheunitedstates20002010 AT ericbschneider encephalitishospitalizationratesandinpatientmortalityintheunitedstates20002010 AT arunvenkatesan encephalitishospitalizationratesandinpatientmortalityintheunitedstates20002010
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Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010.

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