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Neurology. 2014 Feb 4;82(5):443-51. doi: 10.1212/WNL.0000000000000086. Epub 2014 Jan 2.

Burden of encephalitis-associated hospitalizations in the United States, 1998-2010.

Author information

1
From the Epidemic Intelligence Service (N.M.V.) and Division of High-Consequence Pathogens and Pathology (N.M.V., R.C.H., J.M.M., J.B., J.S.), Centers for Disease Control and Prevention, Atlanta, GA; and Healthcare Cost and Utilization Project (C.A.S.), Center for Delivery, Organizations, and Markets, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, MD.

Abstract

OBJECTIVE:

To estimate the burden of encephalitis-associated hospitalizations in the United States for 1998-2010.

METHODS:

Using the Nationwide Inpatient Sample, a nationally representative database of hospitalizations, estimated numbers and rates of encephalitis-associated hospitalizations for 1998-2010 were calculated. Etiology and outcome of encephalitis-associated hospitalizations were examined, as well as accompanying diagnoses listed along with encephalitis on the discharge records. Total hospital charges (in 2010 US dollars) were assessed.

RESULTS:

An estimated 263,352 (standard error: 3,017) encephalitis-associated hospitalizations occurred in the United States during 1998-2010, which corresponds to an average of 20,258 (standard error: 232) encephalitis-associated hospitalizations per year. A fatal outcome occurred in 5.8% (95% confidence interval [CI]: 5.6%-6.0%) of all encephalitis-associated hospitalizations and in 10.1% (95% CI: 9.2%-11.2%) and 17.1% (95% CI: 14.6%-20.0%) of encephalitis-associated hospitalizations in which a code for HIV or a tissue or organ transplant was listed, respectively. The proportion of encephalitis-associated hospitalizations in which an etiology for encephalitis was specified was 50.3% (95% CI: 49.6%-51.0%) and that for which the etiology was unspecified was 49.7% (95% CI: 49.0%-50.4%). Total charges for encephalitis-associated hospitalizations in 2010 were an estimated $2.0 billion.

CONCLUSIONS:

Encephalitis remains a major public health concern in the United States. Among the large number of encephalitis-associated hospitalizations for which an etiology is not reported may be novel infectious and noninfectious forms of encephalitis. Associated conditions such as HIV or transplantation increase the risk of a fatal outcome from an encephalitis-associated hospitalization and should be monitored.

PMID:
24384647
DOI:
10.1212/WNL.0000000000000086
[Indexed for MEDLINE]

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