Birmingham Neuro-Ophthalmology Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK.
Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK.
Eye (Lond). 2019 Mar;33(3):478-485. doi: 10.1038/s41433-018-0238-5. Epub 2018 Oct 24.
To quantify the hospital burden and health economic impact of idiopathic intracranial hypertension.
Hospital Episode Statistics (HES) national data was extracted between 1st January 2002 and 31st December 2016. All those within England with a diagnosis of idiopathic intracranial hypertension were included. Those with secondary causes of raised intracranial pressure such as tumours, hydrocephalus and cerebral venous sinus thrombosis were excluded.
A total of 23,182 new IIH cases were diagnosed. Fifty-two percent resided in the most socially deprived areas (quintiles 1 and 2). Incidence rose between 2002 and 2016 from 2.3 to 4.7 per 100,000 in the general population. Peak incidence occurred in females aged 25 (15.2 per 100,000). 91.6% were treated medically, 7.6% had a cerebrospinal fluid diversion procedure, 0.7% underwent bariatric surgery and 0.1% had optic nerve sheath fenestration. Elective caesarean sections rates were significantly higher in IIH (16%) compared to the general population (9%), p < 0.005. Admission rates rose by 442% between 2002 and 2014, with 38% having repeated admissions in the year following diagnosis. Duration of hospital admission was 2.7 days (8.8 days for those having CSF diversion procedures). Costs rose from £9.2 to £50 million per annum over the study period with costs forecasts of £462 million per annum by 2030.
IIH incidence is rising (by greater than 100% over the study), highest in areas of social deprivation and mirroring obesity trends. Re-admissions rates are high and growing yearly. The escalating population and financial burden of IIH has wide reaching implications for the health care system.
量化特发性颅内高压的医院负担和健康经济影响。
提取了 2002 年 1 月 1 日至 2016 年 12 月 31 日期间的国家医院入院统计（HES）数据。所有在英格兰被诊断为特发性颅内高压的患者均被纳入研究。那些因肿瘤、脑积水和脑静脉窦血栓形成等继发性颅内压升高的患者被排除在外。
共诊断出 23182 例新的 IIH 病例。52%的患者居住在最贫困的地区（五分位 1 和 2）。2002 年至 2016 年，发病率从普通人群中的每 10 万人 2.3 例上升至 4.7 例。发病率峰值出现在 25 岁的女性（每 10 万人 15.2 例）。91.6%的患者接受了药物治疗，7.6%的患者接受了脑脊液分流术，0.7%的患者接受了减肥手术，0.1%的患者接受了视神经鞘开窗术。与普通人群（9%）相比，IIH 患者行择期剖宫产的比例明显更高（16%），p<0.005。2002 年至 2014 年，住院率上升了 442%，诊断后一年内有 38%的患者再次住院。住院时间为 2.7 天（接受 CSF 分流术的患者为 8.8 天）。研究期间，医疗费用从每年 920 万英镑增加到 5000 万英镑，预计到 2030 年，每年的费用将达到 4.62 亿英镑。
IIH 的发病率正在上升（在研究期间增加了 100%以上），在社会贫困地区发病率最高，与肥胖趋势相吻合。再入院率高且逐年上升。IIH 人群的不断增加和医疗费用的不断增加，对医疗保健系统产生了广泛的影响。
