Discharge status and in-hospital mortality in posterior reversible encephalopathy syndrome
Version of Record online: 13 DEC 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Neurologica Scandinavica
Volume 130, Issue 1, pages 34–39, July 2014
How to Cite
Discharge status and in-hospital mortality in posterior reversible encephalopathy syndrome. Acta Neurol Scand 2014: 130: 34–39. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd., , , .
- Issue online: 10 JUN 2014
- Version of Record online: 13 DEC 2013
- Manuscript Accepted: 18 NOV 2013
- Federal Ministry of Education and Research. Grant Number: 01 EO 0801
- German Research Foundation. Grant Number: SFB-TR43
- Volkswagen Foundation
- European Stroke Network
- posterior reversible encephalopathy syndrome;
- discharge status;
- hypertensive encephalopathy
Posterior reversible encephalopathy syndrome is a serious and increasingly recognized disorder, but data from observational studies on outcome and mortality in posterior reversible encephalopathy syndrome (PRES) are scarce. We aimed to determine the frequency and associations of in-hospital death and discharge status in a large cohort of patients with PRES.
We retrospectively reviewed the radiological report databases of our university hospitals between January 1999 and March 2011 for patients with PRES. Patients fulfilling the criteria for PRES after detailed investigation of clinical charts and imaging studies were included. Clinical charts, paraclinical and brain imaging data at onset as well as available data on in-hospital mortality and discharge status were analyzed.
A total of 103 patients were included. Five (4.8%) patients died during hospital stay, 27 (26.2%) remained hospitalized after discharge. In univariate analyses, significant differences were found between patients discharged home from hospital and patients referred to rehabilitation or who died in hospital for the following variables: severe edema (P = 0.013), etiology of PRES (P = 0.001), altered mental state at onset (P = 0.003), altered coagulation (P = 0.004), and length of hospital stay >30 days (P < 0.001).
Features of a severe course of PRES such as severe edema and altered mental state are significantly more frequent in patients who were referred to inpatient rehabilitation or died in hospital. Prospective studies are warranted to establish factors that are associated with unfavorable outcome in PRES.