Parth Bhatt1, Leonita Bray2, Sneha Raju3, Fredrick Dapaah-Siakwan4, Achint Patel5, Riddhi Chaudhari6, Keyur Donda4, Neel S Bhatt7, Mihir Dave5, Vijay Gandhi Linga3, Anusha Lekshminarayanan8, Samir V Patel9, Zeenia C Billimoria10, Samuel Zuckerman3, Priyank Yagnik11, Dinesh Singh12. 1. Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX. Electronic address: 5.parthbhatt@gmail.com. 2. Department of Pediatrics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3. Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX. 4. Department of Pediatrics, University of Miami, Coral Gables, FL. 5. Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY. 6. Department of Pediatrics, University of Connecticut, Farmington, CT. 7. Department of Pediatrics, Division of Hematology/ Oncology/ BMT, Medical College of Wisconsin, Milwaukee, WI. 8. Department of Internal Medicine, Mercy Health, Cincinnati, OH. 9. Department of Internal Medicine, Sparks Health Systems, Fort Smith, AR. 10. Department of Pediatrics, University of Washington; Seattle, WA. 11. Department of Pediatrics, University of Kansas School of Medicine, Wichita, KS. 12. Department of Pediatrics, Tulane University, New Orleans, LA; Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX.
Abstract
OBJECTIVE: To determine the temporal trends in the epidemiology of acute disseminated encephalomyelitis (ADEM) and hospitalization outcomes in the US from 2006 through 2014. STUDY DESIGN: Pediatric (≤18 years of age) hospitalizations with ADEM discharge diagnosis were identified from the National (Nationwide) Inpatient Sample (NIS) for years 2006 through 2014. Trends in the incidence of ADEM with respect to age, sex, race, and region were examined. Outcomes of ADEM in terms of mortality, length of stay (LOS), cost of hospitalization, and seasonal variation were analyzed. NIS includes sampling weight. These weights were used to generate national estimates. P value of < .05 was considered significant. RESULTS: Overall incidence of ADEM associated pediatric hospitalizations from 2006 through 2014 was 0.5 per 100 000 population. Between 2006 through 2008 and 2012 through 2014, the incidence of ADEM increased from 0.4 to 0.6 per 100 000 (P-trend <.001). Black and Hispanic children had a significantly increased incidence of ADEM during the study period (0.2-0.5 per 100 000 population). There was no sex preponderance and 67% of ADEM hospitalizations were in patients <9 years old. From 2006 through 2008 to 2012 through 2014 (1.1%-1.5%; P-trend 0.07) and median LOS (4.8-5.5 days; Ptrend = .3) remained stable. However, median inflation adjusted cost increased from $11 594 in 2006 through 2008 to $16 193 in 2012 through 2014 (Ptrend = .002). CONCLUSION: In this large nationwide cohort of ADEM hospitalizations, the incidence of ADEM increased during the study period. Mortality and LOS have remained stable over time, but inflation adjusted cost of hospitalizations increased.
OBJECTIVE: To determine the temporal trends in the epidemiology of acute disseminated encephalomyelitis (ADEM) and hospitalization outcomes in the US from 2006 through 2014. STUDY DESIGN: Pediatric (≤18 years of age) hospitalizations with ADEM discharge diagnosis were identified from the National (Nationwide) Inpatient Sample (NIS) for years 2006 through 2014. Trends in the incidence of ADEM with respect to age, sex, race, and region were examined. Outcomes of ADEM in terms of mortality, length of stay (LOS), cost of hospitalization, and seasonal variation were analyzed. NIS includes sampling weight. These weights were used to generate national estimates. P value of < .05 was considered significant. RESULTS: Overall incidence of ADEM associated pediatric hospitalizations from 2006 through 2014 was 0.5 per 100 000 population. Between 2006 through 2008 and 2012 through 2014, the incidence of ADEM increased from 0.4 to 0.6 per 100 000 (P-trend <.001). Black and Hispanic children had a significantly increased incidence of ADEM during the study period (0.2-0.5 per 100 000 population). There was no sex preponderance and 67% of ADEM hospitalizations were in patients <9 years old. From 2006 through 2008 to 2012 through 2014 (1.1%-1.5%; P-trend 0.07) and median LOS (4.8-5.5 days; Ptrend = .3) remained stable. However, median inflation adjusted cost increased from $11 594 in 2006 through 2008 to $16 193 in 2012 through 2014 (Ptrend = .002). CONCLUSION: In this large nationwide cohort of ADEM hospitalizations, the incidence of ADEM increased during the study period. Mortality and LOS have remained stable over time, but inflation adjusted cost of hospitalizations increased.