Burden of herpes simplex virus encephalitis in the United States
Burden of herpes simplex virus encephalitis in the United States
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DOI：
10.1007/s00415-017-8516-x
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发表时间：
2017-06-01
影响因子：
6
通讯作者：
Mitsias, P.
中科院分区：
文献类型：
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作者：
Modi, S.;Mahajan, Abhimanyu;Mitsias, P.
单纯疱疹病毒性脑炎(HSVE)是一种引起公共卫生关注的疾病，但其对美国医疗保健的负担最近还没有得到充分的评估。我们的目的是通过分析来自全国代表性数据库的数据来确定近十年来HSVE的发生率、并发症和预后。利用医疗成本和利用项目数据库来确定HSVE的初级出院诊断患者。评估了年度住院率，并确定了几个预先选定的住院并发症。使用回归分析来确定死亡率预测因素。将主要流行病学因素与其他国家的流行病学因素进行比较。本研究共纳入4871例单纯疱疹病毒性脑炎患者。年住院率新生儿为10.3+/-2.2例/百万，儿童为2.4+/-0.3例/百万，成人为6.4+/-0.4例/百万。中位年龄57岁，男女之比为1：1。癫痫发作(38.4%)、癫痫持续状态(5.5%)、急性呼吸衰竭(20.1%)、缺血性中风(5.6%)、颅内出血(2.7%)等中枢神经系统并发症的发生率与病死率显著相关。新生儿、儿童和成人的住院死亡率分别为6.9%、1.2%和7.7%。HSVE仍然是一种发病率和死亡率都很高的潜在致命性传染病。这项研究中最新的流行病学数据可能有助于理解这种公共卫生疾病，患者结局数据可能具有预后意义。
Herpes simplex virus encephalitis (HSVE) is a disease of public health concern, but its burden on the healthcare of United States has not been adequately assessed recently. We aimed to define the incidence, complications and outcomes of HSVE in the recent decade by analyzing data from a nationally representative database. Healthcare Cost and Utilization Project databases were utilized to identify patients with primary discharge diagnosis of HSVE. Annual hospitalization rate was estimated and several preselected inpatient complications were identified. Regression analyses were used to identify mortality predictors. Key epidemiological factors were compared with those from other countries. Total 4871 patients of HSVE were included in our study. The annual hospitalization rate was 10.3 +/- 2.2 cases/million in neonates, 2.4 +/- 0.3 cases/million in children and 6.4 +/- 0.4 cases/million in adults. Median age was 57 years and male:female incidence ratio was 1:1. Rates of some central nervous system complications were seizures (38.4%), status epilepticus (5.5%), acute respiratory failure (20.1%), ischemic stroke (5.6%) and intracranial hemorrhage (2.7%), all of which were significantly associated with mortality. In-hospital mortality in neonates, children and adults were 6.9, 1.2 and 7.7%, respectively. HSVE still remains a potentially lethal infectious disease with high morbidity and mortality. Most recent epidemiological data in this study may help understanding this public health disease, and the patient outcome data may have prognostic significance.