Abstract
Brain abscess (BA) is a severe neurological emergency, which remains a challenge for physicians despite medical advancements. The purpose of this study is to describe the epidemiology of BA in Taiwan and to investigate potential factors affecting the survival of patients with BA. By using the Taiwan National Health Insurance Research Database, we identified hospitalized patients with a discharge diagnosis of pyogenic BA (324.X) between 2000 and 2013. The incidence and in-hospital mortality of BA were calculated based on both age and sex. A total of 6027 BA cases were identified. The overall incidence of BA was 1.88 (95% CI: 1.83–1.93) per 100,000 person-years and increased with age, from 0.58 per 100,000 person-years in individuals aged 0–14 years to 4.67 per 100,000 person-years in those over 60 years of age. The male-to-female incidence ratio was 2.37 (95% CI: 2.24–2.50), with a mountain-shaped distribution across ages peaking at 40–44 years. The in-hospital mortality also increased with age, from 4.22% (95% CI: 2.54–6.97) at 0–14 years to 17.34% (95% CI: 15.79–19.02) in individuals over 60 years of age, without a gender difference (11.9% for males, 12.5% for females). Age, stroke, septicemia, pneumonia, meningitis, and hepatitis were associated with increased risk of in-hospital mortality. There was a male predominance for BA, and both the incidence and in-hospital mortality rates increased with age. Infection-related disease such as septicemia, pneumonia and meningitis were important factors associated with in-hospital mortality. In addition to the original treatment of BA, we suggest paying close attention to potential infections to improve the outcome of BA patients.
Highlights
Brain abscess (BA) is a rare but life-threatening disease
We propose that the low number of BA cases in the young age group may be associated with fewer severe otorhinogenic infections in Taiwan
Consistent with the finding of previous studies that pulmonary disease and hepatitis can increase the risk of in-hospital mortality in trauma patients [22, 23]; our study found pulmonary disease and hepatitis increase the risk of in-hospital mortality in BA patients
Summary
Brain abscess (BA) is a rare but life-threatening disease. The main strategies for BA treatment include surgical intervention and antibiotic therapy. Previous studies examined various characteristics of BA, such as age, gender, location, symptoms, pathogens, and outcomes [1,2,3,4,5,6], few studies have assessed the incidence of BA. These studies included only a small number of cases [7, 8].
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