Demographic Disparities in the Incidence, Clinical Characteristics, and Outcome of Posterior Reversible Encephalopathy Syndrome in the United States
Fadar Oliver Otite, Smit Patel, Nnabuchi Anikpezie, Haydn Hoffman, Timothy Beutler, Emmanuel Akano, Ehimen Aneni, Oluwatomi Lamikanra, Chukwuemeka U Osondu, Claribel Wee, Devin Burke, Karen C. Albright, Julius Gene Latorre, Luis J. Mejico, Priyank Khandelwal, Seemant Chaturvedi
Abstract
<h3>Background:</h3> To estimate age, sex and race-specific incidence of posterior reversible encephalopathy syndrome (PRES) in the United States. <h3>Methods:</h3> We conducted a retrospective cohort study using the State Inpatient Database of Florida (2016-2019), Maryland (2016-2019) and New York (2016-2018). All new cases of PRES in adults (≥18 years) were combined with Census data to compute incidence. We evaluated the generalizability of incident estimates to the entire country using the 2016-2019 National Readmissions Database (NRD). <h3>Results:</h3> Across the study period, there were 3,716 incident hospitalizations for PRES in the selected states. The age and sex-standardized incidence of PRES was 2.7 (95% CI 2.5-2.8) cases/100,000/year. Incidence in female patients was >2-times that of male patients (3.7 vs 1.6 cases/100,000/year, <i>p</i><0.001). Incidence increased with age in both sexes (<i>p</i>-trend <0.001). Similar demographic distribution of first hospitalization for PRES was also noted in the entire country using the NRD. Age and sex-standardized PRES incidence in Black patients (4.2/100,000/year) was significantly greater than in Non-Hispanic White (2.7/100,000/year) and Hispanic patients (1.2/100,000/year) (p<0.001 for pairwise comparisons). <h3>Conclusion:</h3> The incidence of PRES in the US is approximately 3/100,000/year but incidence in female patients is >two-times that of male patients. PRES incidence is higher in Black compared to Non-Hispanic White and Hispanic patients.