ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
Factors associated with mortality in posterior reversible encephalopathy syndrome: a nationwide analysis.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundTo 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).
methodsHospitalizations 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).
findingsThere 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.
conclusionRespiratory 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.
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