Magid-Bernstein Jessica, Omran Setareh S, Parikh Neal S, Merkler Alexander E, Navi Babak, Kamel Hooman
From the Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology (J.M.-B., S.S.O., N.S.P., A.E.M., B.N., H.K.), Weill Cornell Medicine, New York, NY; and Department of Neurology (S.S.O.), University of Colorado School of Medicine, Aurora.
Neurology. 2021 Jul 19;97(3):e248-e253. doi: 10.1212/WNL.0000000000012223.
To estimate the incidence of hospitalization for reversible cerebral vasoconstriction syndrome (RCVS), we identified RCVS-related hospital admissions across 11 US states in 2016.
We tested the validity of ICD-10 code I67.841 in 79 patients with hospital admissions for RCVS or other cerebrovascular diseases at 1 academic and 1 community hospital. After determining that this code had a sensitivity of 100% (95% confidence interval [CI], 82%-100%) and a specificity of 90% (95% CI, 79%-96%), we applied it to administrative data from the Healthcare Cost and Utilization Project on all hospital admissions across 11 states. Age- and sex-standardized RCVS incidence was calculated using census data. Descriptive statistics were used to analyze associated diagnoses.
Across 5,067,250 hospital admissions in our administrative data, we identified 222 patients with a discharge diagnosis of RCVS in 2016. The estimated annual age- and sex-standardized incidence of RCVS hospitalization was 2.7 (95% CI, 2.4-3.1) cases per million adults. Many patients had concomitant neurologic diagnoses, including subarachnoid hemorrhage (37%), ischemic stroke (16%), and intracerebral hemorrhage (10%). In the 90 days before the index admission, 97 patients had an emergency department (ED) visit and 34 patients a hospital admission, most commonly for neurologic, psychiatric, and pregnancy-related diagnoses. Following discharge from the RCVS hospital admission, 58 patients had an ED visit and 31 had a hospital admission, most commonly for neurologic diagnoses.
Using population-wide data, we estimated the age- and sex-standardized incidence of hospitalization for RCVS in US adults as approximately 3 per million per year.
为了估算可逆性脑血管收缩综合征（RCVS）的住院发病率，我们确定了2016年美国11个州与RCVS相关的住院病例。
我们在1家学术医院和1家社区医院对79例因RCVS或其他脑血管疾病住院的患者，测试了ICD-10编码I67.841的有效性。在确定该编码的敏感性为100%（95%置信区间[CI]，82%-100%）、特异性为90%（95%CI，79%-96%）后，我们将其应用于医疗成本和利用项目中11个州所有住院病例的管理数据。使用人口普查数据计算年龄和性别标准化的RCVS发病率。采用描述性统计分析相关诊断。
在我们的管理数据中，5,067,250例住院病例里，我们确定了2016年222例出院诊断为RCVS的患者。RCVS住院的年龄和性别标准化年发病率估计为每百万成年人2.7例（95%CI，2.4-3.1）。许多患者伴有神经系统诊断，包括蛛网膜下腔出血（37%）、缺血性卒中（16%）和脑出血（10%）。在首次入院前90天内，97例患者曾到急诊科就诊，34例患者曾住院，最常见的诊断为神经系统、精神和妊娠相关疾病。RCVS住院出院后，58例患者曾到急诊科就诊，31例患者曾住院，最常见的诊断为神经系统疾病。
利用全人群数据，我们估计美国成年人中RCVS住院的年龄和性别标准化发病率约为每年每百万3例。
