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Background <p>To identify demographic and clinical factors associated with in-hospital mortality among hospitalizations of adults with posterior reversible encephalopathy syndrome (PRES) using the National Inpatient Sample (NIS) in the United States (US).</p> Methods <p>Hospitalizations for PRES in patients ≥ 18 years were abstracted from the NIS (2016–2022). To identify clinical factors associated with in-hospital mortality, univariable logistic regression models were estimated and significant predictors were retained in a multivariable logistic regression model. Collinearity was assessed via variance inflation factors. Association was quantified using adjusted odds ratios (aOR).</p> Findings <p>There were an estimated 75,830 PRES hospitalizations, of which, 3,665 in-hospital deaths occurred (4.8%). Decedents were older, had longer stays, and higher costs. In the adjusted model, the strongest factors associated with increased mortality were respiratory failure (aOR 5.43; 95% CI 4.40–6.71), sepsis (aOR 2.45; 95% CI 2.02–2.96), and ischemic stroke (aOR 2.25; 95% CI 1.86–2.72). Additional independent risk factors included cerebral edema, coma, intracerebral hemorrhage, severe liver disease, subarachnoid hemorrhage, kidney disorders, status epilepticus, encephalitis/encephalomyelitis, malignancy, complications of transplanted organs, and COVID-19. Documented hypertensive crisis (OR 0.63; 95% CI: 0.52 to 0.75) and history of epilepsy/seizures (OR 0.67; 95% CI: 0.55 to 0.81) were associated with lower odds of death.</p> Conclusion <p>Respiratory failure, sepsis, and cerebrovascular complications drive in-hospital mortality in PRES. Early airway protection, aggressive supportive care, and prompt neurovascular evaluation for high-risk patients may improve outcomes. Prospective studies with granular clinical and imaging data are needed to refine prognostic models.</p>

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Factors associated with mortality in posterior reversible encephalopathy syndrome: a nationwide analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月24日

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  • Ali Al-Salahat,
  • Richard Cheung,
  • Danielle B. Dilsaver,
  • Amelia Pham,
  • Ripudaman Kahlon,
  • Muhammad Roshan Asghar,
  • Rohan Sharma

摘要

Background

To identify demographic and clinical factors associated with in-hospital mortality among hospitalizations of adults with posterior reversible encephalopathy syndrome (PRES) using the National Inpatient Sample (NIS) in the United States (US).

Methods

Hospitalizations for PRES in patients ≥ 18 years were abstracted from the NIS (2016–2022). To identify clinical factors associated with in-hospital mortality, univariable logistic regression models were estimated and significant predictors were retained in a multivariable logistic regression model. Collinearity was assessed via variance inflation factors. Association was quantified using adjusted odds ratios (aOR).

Findings

There were an estimated 75,830 PRES hospitalizations, of which, 3,665 in-hospital deaths occurred (4.8%). Decedents were older, had longer stays, and higher costs. In the adjusted model, the strongest factors associated with increased mortality were respiratory failure (aOR 5.43; 95% CI 4.40–6.71), sepsis (aOR 2.45; 95% CI 2.02–2.96), and ischemic stroke (aOR 2.25; 95% CI 1.86–2.72). Additional independent risk factors included cerebral edema, coma, intracerebral hemorrhage, severe liver disease, subarachnoid hemorrhage, kidney disorders, status epilepticus, encephalitis/encephalomyelitis, malignancy, complications of transplanted organs, and COVID-19. Documented hypertensive crisis (OR 0.63; 95% CI: 0.52 to 0.75) and history of epilepsy/seizures (OR 0.67; 95% CI: 0.55 to 0.81) were associated with lower odds of death.

Conclusion

Respiratory failure, sepsis, and cerebrovascular complications drive in-hospital mortality in PRES. Early airway protection, aggressive supportive care, and prompt neurovascular evaluation for high-risk patients may improve outcomes. Prospective studies with granular clinical and imaging data are needed to refine prognostic models.