Original ArticlesTemporal Trends of Pediatric Hospitalizations with Acute Disseminated Encephalomyelitis in the United States: An Analysis from 2006 to 2014 using National Inpatient Sample
Section snippets
Methods
National (Nationwide) Inpatient Sample (NIS) databases from the years 2006-2014 were used to derive our study population. NIS is one of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP) that is sponsored by Agency for Healthcare Research and Quality.14 NIS database contains inpatient data including clinical and resource use information derived from billing data submitted by hospitals to statewide data organizations across US. The 2014 NIS
Results
We identified a total of 55 667 114 pediatric hospitalizations within the NIS between 2006 and 2014 of which 3319 had an ADEM diagnosis with International Classification of Diseases, Ninth Revision, Clinical Modification code 323.61. Of the total ADEM cases identified, ADEM was the primary diagnosis in 73 cases and the secondary diagnosis in 3246 cases. The overall incidence of ADEM for the study period was 0.5 per 100 000 children/year. Table I describes the baseline and demographic
Discussion
In this analysis using the NIS, a large nationally representative database of inpatient hospitalizations in the US, we have demonstrated upward trends in the incidence of ADEM-associated pediatric hospitalizations in the US from 2006 to 2014. Upward trends of incidence were seen across all age groups with peak incidence at age 2 years. Increased incidence also was seen in black and Hispanic children, and across all regions of the US except the Northeast. Seasonal variation was observed, with
Data Statement
Data sharing statement available at www.jpeds.com.
References (47)
Acute disseminated encephalomyelitis
Acute disseminated encephalomyelitis and other inflammatory demyelinating variants
Acute disseminated encephalomyelitis: its sequelae and its relationship to disseminated sclerosis
Lancet
(1931)- et al.
Short term outcome of ADEM: results from a retrospective cohort study from South India
Mult Scler Relat Disord
(2017) - et al.
Temporal trends, predictors, and outcomes of in-hospital gastrointestinal bleeding associated with percutaneous coronary intervention
Am J Cardiol
(2016) - et al.
Clinical advantages of 3.0T MRI over 1.5T
Eur J Radiol
(2008) - et al.
The relationship between the location of pediatric intensive care unit facilities and child death from trauma: a county-level ecologic study
J Pediatr
(2005) - et al.
Paediatric multiple sclerosis and acute disseminated encephalomyelitis in Germany: results of a nationwide survey
Eur J Pediatr
(2007) Acute disseminated encephalomyelitis
J Child Neurol
(2012)- et al.
Incidence of acquired demyelination of the CNS in Canadian children
Neurology
(2009)
Acute disseminated encephalomyelitis
Postgrad Med J
Acute disseminated encephalomyelitis: recognition in the hands of general paediatricians
Arch Dis Child
Variation in treatment and outcomes of children with acute disseminated encephalomyelitis
Neurology
Disease course and outcome of acute disseminated encephalomyelitis is more severe in adults than in children
Mult Scler
Severe acute disseminated encephalomyelitis: a paediatric intensive care population-based study
Mult Scler
Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children
Neurology
HCUPnet: healthcare cost and utilization project
National trends in neonatal extracorporeal membrane oxygenation in the United States
J Perinatol
Temporal trends of splenectomy in pediatric hospitalizations with immune thrombocytopenia
Pediatr Blood Cancer
HCUP NIS description of data elements
HCUP Cost-to-Charge Ratio files (CCR)
CPI inflation calculator
HCUP NIS trend weights
Cited by (14)
Acute haemorrhagic leukoencephalitis (AHLE) – our experience and a short review
2021, Journal of NeuroimmunologyCitation Excerpt :So, AHLE presents distinctly from classical ADEM, and the situation may pose a diagnostic challenge (Nabi et al., 2016; Magun et al., 2016). ADEM itself is an extremely uncommon disease with an incidence quoted at just 0.32 and 0.5 per 1,00,000 population in a couple of recent studies (Chen et al., 2015; Bhatt et al., 2019). AHLE is a rare variant of ADEM and was seen in around 2% of ADEM children in a study (Tenembaum et al., 2002; Leake et al., 2004).
U.S. Population-Based background incidence rates of medical conditions for use in safety assessment of COVID-19 vaccines
2021, VaccineCitation Excerpt :As with other central nervous system demyelinating diseases, there are few data on ADEM incidence—a disorder most common in children—in the literature, primarily due to difficulties in making the diagnosis [35]. A retrospective review of the NIS (2006–2014) reported a pediatric (≤18y) hospitalization rate of 0.5/100,000, with no difference between males and females (Supplemental Table 6) [35]. A California study (1991–2000) determined rates by age strata: 0.4/100,000 in children < 20y (0.6/100,000 in children 0–4y and 0.8/100,000 in children 5–9y) [36].
The authors declare no conflict of interest.
Portions of this study were presented as a poster at the American Academy of Pediatrics National Conference and Exhibition, November 2-6, 2018, Orlando, Florida.