Abstract WP155: Epidemiology of Posterior Reversible Encephalopathy Syndrome (PRES) in the United States: A National Inpatient Sample Study

Abstract

Introduction: Posterior reversible encephalopathy syndrome (PRES) is an increasingly recognized and potentially devastating cerebral dysregulation syndrome. The epidemiology of PRES and its associated manifestations have been underreported. We therefore sought to determine the prevalence and clinical severity of PRES among hospitalized patients in the United States (US). Methods: We conducted a retrospective cohort study using US data from the National Inpatient Sample (NIS) for the years 2016 to 2019. To identify patients with PRES, we used the ICD-10-CM diagnostic code I67.83, which was previously found to have a sensitivity of 100% (95% CI, 87%-100%) and a specificity of 88% (95% CI, 73%-97%) as compared to chart review. To characterize disease severity, we report the coincidence of any stroke (ischemic stroke, intracerebral hemorrhage [ICH], subarachnoid hemorrhage [SAH]) using previously validated ICD-10-CM codes, length of stay, need for mechanical ventilation, and discharge destination. Standard descriptive statistics with 95% CI are used to detail our findings. Results: We identified 39,460 hospitalizations for PRES among adults, which accounts for 0.03% of hospitalizations during the study period. The median age of PRES patients was 57 years (IQR, 41-67), 27,583 (69.9%) were female, and 26,399 (66.9%) were of White race. A total of 33,107 patients (83.9%) had a history of hypertension. Among patients with PRES, 3,950 (10.0%; 95% CI, 9.4-10.7%) had an ischemic stroke, 1,685 (4.3%; 95% CI, 3.8-4.7%) had ICH, and 995 (2.5%; 95% CI, 2.2-2.9%) had SAH during their index hospitalization. The median length of stay was 6 days (IQR 4-12), one quarter required mechanical ventilation, and half were discharged to home. Conclusion: In a representative US sample, we found that PRES is a rare disorder with relatively low rates of coincident ischemic and hemorrhagic stroke reported at index hospitalization.