Abstract Details

Title Disease Burden, HIV Infection, and In-Hospital Outcomes for Encephalitis in the United States, 2000-2010

Topic Infections/AIDS/Prion Disease

Presentation(s) P04 - (-)

Poster/Presentation
Number 003

Objective

Background BACKGROUND: Etiology and outcomes associated with encephalitis in the U.S. inpatient population have not been well studied in the 21st century.

Design/Methods DESIGN/METHODS: We examined hospitalized patients within the AHRQ Nationwide Inpatient Sample, 2000-2010 with an ICD-9 diagnosis of encephalitis. We described U.S. hospitalization rates for the entire U.S. and HIV populations using estimates from the U.S. Census Bureau (2000-2010) and HIV prevalence estimates from the CDC (2000-2008), respectively.

Results RESULTS: From 2000-2010, there were an estimated 225,008 encephalitis admissions in the U.S. (95% CI: 213,592-236,424); 53% were female with an average age of 45.4 years (SD=0.4). Known and unknown causes each accounted for approximately half of all cases. The leading known broad category of encephalitis was "viral" (21.1%), and the most common individual diagnoses were herpes (14.6%), postinfectious (5.1%), and toxoplasmosis (3.1%). The overall U.S. encephalitis hospitalization rate from 2000-2010 was 6.9 per 100,000 (95% CI: 6.5-7.4). HIV infection was listed among discharge diagnoses for 8.2% of hospitalizations. The rate of encephalitis-associated hospitalizations within the HIV population from 2000-2008 was 162.3 per 100,000 (95% CI: 133.7-190.9), over 20-fold higher than non-HIV cases. Toxoplasmic encephalitides was the most common cause among patients with comorbid HIV (68.4 per 100,000; 95% CI: 43.6-93.1). Encephalitis admissions had an average length of stay of 11.3 days (SD=0.2) and 5.8% mortality rate (95% CI: 5.6-6.0%). Separately, HIV patients demonstrated a 9.8% mortality rate (95% CI: 9.5-10.1%), nearly two-fold greater than non-HIV admissions (p<0.001). Overall, 18.5% of patients had convulsions, 13.4% received mechanical ventilation, and 10.6% had acute respiratory failure.

Conclusions CONCLUSIONS: Encephalitis accounted for a substantial disease burden in the U.S. from 2000-2010 with a high rate of in-hospital mortality, especially among those with HIV.

Authors/Disclosures
Benjamin P. George, MD (U of Rochester, Dept of Neurology) PRESENTER	Dr. George has nothing to disclose.
Arun Venkatesan, MD, PhD (Johns Hopkins Hospital)	Dr. Venkatesan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Pharmaceuticals. The institution of Dr. Venkatesan has received research support from NIH. The institution of Dr. Venkatesan has received research support from U.S. DOD.
Eric B. Schneider, PhD (Yale University, Dept of Surgery)	No disclosure on file
Cherian A. Karunapuzha, MD (Meinders Center for Movement Disorders)	No disclosure on file

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