Abstract TMP51: Predictors Of Severe Disease In Posterior Reversible Encephalopathy Syndrome

Abstract

Background: Despite its name, posterior reversible encephalopathy syndrome (PRES) is not always fully reversible and there might be residual neurologic sequelae or even mortality in a significant minority of patients. Factors predisposing to severe disease course in PRES are largely unclear. The aim of this study was to evaluate the predictors of in-hospital mortality and adverse discharge disposition in patients hospitalized due to PRES. Methods: Hospitalizations due to the primary diagnosis of PRES with known discharge disposition were identified from the Nationwide Readmissions Database 2016-2018. Survey statistics were used to compute national estimates. Univariate and multivariable logistic regression analyses were used to identify factors associated with the study outcomes. P-value <0.01 was considered significant. Results: There were 9,298 patients with PRES (mean±SD age: 56.2±17.6 years; female: 71.2%). Of these, 207 (2.2%) had in-hospital mortality and 4,002 (43.0%) had adverse discharge disposition, defined as discharge to a short-term hospital, a rehabilitation facility, home with in-home healthcare or hospice. Figure 1 shows the independent predictors of the study outcomes. Advanced age, history of cancer, concurrent sepsis, coma, ischemic stroke, and mechanical ventilation were associated with higher in-hospital mortality. Whereas advanced age, female sex, higher Charlson comorbidity index score, mechanical ventilation, and longer length of hospital stay were associated with a higher likelihood of adverse discharge disposition. Conclusion: Nearly half of the hospitalized patients with PRES have severe disease. This study identifies several clinical predictors of severe disease course in PRES.