The Burden of Hospitalisations for Herpes Zoster Ophtalmicus in Spain (1997-2008)

Abstract

Purpose: This epidemiological retrospective survey aims to provide population-based estimates of the burden of hospitalisation for herpes zoster ophthalmicus in Spain during a twelve-year period (1997-2008). Methods: All hospital discharges and deaths related to herpes zoster ophthalmicus in patients older than 30 years old from 1997 to 2008 in Spain were obtained. Differences in proportions were assessed by the Chi-square test. ANOVA was used for multiple comparisons. Poisson regression was used to assess differences in the rates. Results: A total of 3029 hospital discharges in patients older than 30 years old were coded as herpes zoster ophthalmicus. Of those, 1009 were coded as primary cause of hospitalization. This corresponds to a hospitalization rate of 0.94 and 0.31 hospitalizations per 100,000 for any position and first diagnostic position, respectively. The 75% of the total discharges were in immunocompetent patients. The herpes zoster ophthalmicus hospitalization rate increased significantly during the study period. This increase was also observed for immunocompetent patients. A total of 127 and 21 deaths occurred in patients ≥ 30 year-old hospitalized with herpes zoster ophthalmicus in any diagnostic position and principal diagnostic code, respectively during the 12-year study period. Of them, 70 (53.4%) were in immunocompetent patients, and, of those 11 were in patients with HZO in the first diagnosis position. The hospitalization rate and case-fatality rate increase significantly with age from 50 years old onwards. Conclusion: HZO, a vaccine preventable disease, still causes hospitalization and death in adults in Spain.