Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015
To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE). This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2021-09, Vol.15 (9), p.e0009703-e0009703 |
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| creator | Chen, Hsuan-Ying Yang, Chen-Yi Hsieh, Cheng-Yang Yeh, Chun-Yin Chen, Chang-Chun Chen, Yen-Chin Lai, Chung-Chih Harris, Rebecca Claire Ou, Huang-Tz Ko, Nai-Ying Ko, Wen-Chien |
| description | To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).
This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients' healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.
This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p |
| doi_str_mv | 10.1371/journal.pntd.0009703 |
| format | Article |
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This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients' healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.
This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05).
A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0009703</identifier><identifier>PMID: 34520457</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Adults ; Aged ; Basal ganglia ; Biology and Life Sciences ; Cardiovascular disease ; Care and treatment ; Central nervous system diseases ; Complications ; Complications and side effects ; Confidence intervals ; Convulsions ; Costs ; Datasets ; Delivery of Health Care ; Dengue fever ; Diabetes mellitus ; Diagnosis ; Disease control ; Economics ; Encephalitis ; Encephalitis, Japanese - economics ; Encephalitis, Japanese - epidemiology ; Encephalitis, Japanese - prevention & control ; Encephalopathy ; Enzymes ; Epidemiology ; Epilepsy ; Female ; Health care ; Health Facilities - economics ; Health services utilization ; Health Surveys ; Humans ; Immunization ; Infections ; Japanese encephalitis ; Japanese Encephalitis Vaccines - administration & dosage ; Length of stay ; Male ; Medical care ; Medical care, Cost of ; Medical prognosis ; Medical records ; Medicine and Health Sciences ; Mental disorders ; Middle Aged ; Mortality ; Movement disorders ; Neurological complications ; Ostomy ; Patients ; People and Places ; Retrospective Studies ; Social Sciences ; Statistics ; Survival ; Taiwan - epidemiology ; Tropical diseases ; Uses ; Utilization ; Vaccination ; Vector-borne diseases ; Young Adult</subject><ispartof>PLoS neglected tropical diseases, 2021-09, Vol.15 (9), p.e0009703-e0009703</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Chen et al 2021 Chen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-7b14472885ad5958ee61f9bad98e6e86b9041def8201be6d25e390db4d7c516f3</citedby><cites>FETCH-LOGICAL-c624t-7b14472885ad5958ee61f9bad98e6e86b9041def8201be6d25e390db4d7c516f3</cites><orcidid>0000-0002-0164-3468 ; 0000-0002-5475-7848 ; 0000-0002-3007-2537 ; 0000-0001-7497-149X ; 0000-0001-7353-3383 ; 0000-0002-2636-1520 ; 0000-0002-8772-4073 ; 0000-0003-1110-2582 ; 0000-0003-4422-1596</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486099/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486099/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34520457$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gromowski, Gregory</contributor><creatorcontrib>Chen, Hsuan-Ying</creatorcontrib><creatorcontrib>Yang, Chen-Yi</creatorcontrib><creatorcontrib>Hsieh, Cheng-Yang</creatorcontrib><creatorcontrib>Yeh, Chun-Yin</creatorcontrib><creatorcontrib>Chen, Chang-Chun</creatorcontrib><creatorcontrib>Chen, Yen-Chin</creatorcontrib><creatorcontrib>Lai, Chung-Chih</creatorcontrib><creatorcontrib>Harris, Rebecca Claire</creatorcontrib><creatorcontrib>Ou, Huang-Tz</creatorcontrib><creatorcontrib>Ko, Nai-Ying</creatorcontrib><creatorcontrib>Ko, Wen-Chien</creatorcontrib><title>Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).
This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients' healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.
This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05).
A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.</description><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Basal ganglia</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular disease</subject><subject>Care and treatment</subject><subject>Central nervous system diseases</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Confidence intervals</subject><subject>Convulsions</subject><subject>Costs</subject><subject>Datasets</subject><subject>Delivery of Health Care</subject><subject>Dengue fever</subject><subject>Diabetes mellitus</subject><subject>Diagnosis</subject><subject>Disease control</subject><subject>Economics</subject><subject>Encephalitis</subject><subject>Encephalitis, Japanese - economics</subject><subject>Encephalitis, Japanese - epidemiology</subject><subject>Encephalitis, Japanese - prevention & control</subject><subject>Encephalopathy</subject><subject>Enzymes</subject><subject>Epidemiology</subject><subject>Epilepsy</subject><subject>Female</subject><subject>Health care</subject><subject>Health Facilities - economics</subject><subject>Health services utilization</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Immunization</subject><subject>Infections</subject><subject>Japanese encephalitis</subject><subject>Japanese Encephalitis Vaccines - administration & dosage</subject><subject>Length of stay</subject><subject>Male</subject><subject>Medical care</subject><subject>Medical care, Cost of</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Movement disorders</subject><subject>Neurological complications</subject><subject>Ostomy</subject><subject>Patients</subject><subject>People and Places</subject><subject>Retrospective Studies</subject><subject>Social Sciences</subject><subject>Statistics</subject><subject>Survival</subject><subject>Taiwan - epidemiology</subject><subject>Tropical diseases</subject><subject>Uses</subject><subject>Utilization</subject><subject>Vaccination</subject><subject>Vector-borne diseases</subject><subject>Young 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neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015</title><author>Chen, Hsuan-Ying ; Yang, Chen-Yi ; Hsieh, Cheng-Yang ; Yeh, Chun-Yin ; Chen, Chang-Chun ; Chen, Yen-Chin ; Lai, Chung-Chih ; Harris, Rebecca Claire ; Ou, Huang-Tz ; Ko, Nai-Ying ; Ko, Wen-Chien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c624t-7b14472885ad5958ee61f9bad98e6e86b9041def8201be6d25e390db4d7c516f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Aged</topic><topic>Basal ganglia</topic><topic>Biology and Life Sciences</topic><topic>Cardiovascular disease</topic><topic>Care and treatment</topic><topic>Central nervous system diseases</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Confidence intervals</topic><topic>Convulsions</topic><topic>Costs</topic><topic>Datasets</topic><topic>Delivery of Health Care</topic><topic>Dengue fever</topic><topic>Diabetes mellitus</topic><topic>Diagnosis</topic><topic>Disease control</topic><topic>Economics</topic><topic>Encephalitis</topic><topic>Encephalitis, Japanese - economics</topic><topic>Encephalitis, Japanese - epidemiology</topic><topic>Encephalitis, Japanese - prevention & control</topic><topic>Encephalopathy</topic><topic>Enzymes</topic><topic>Epidemiology</topic><topic>Epilepsy</topic><topic>Female</topic><topic>Health care</topic><topic>Health Facilities - economics</topic><topic>Health services utilization</topic><topic>Health Surveys</topic><topic>Humans</topic><topic>Immunization</topic><topic>Infections</topic><topic>Japanese encephalitis</topic><topic>Japanese Encephalitis Vaccines - administration & dosage</topic><topic>Length of stay</topic><topic>Male</topic><topic>Medical care</topic><topic>Medical care, Cost of</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medicine and Health Sciences</topic><topic>Mental disorders</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Movement disorders</topic><topic>Neurological complications</topic><topic>Ostomy</topic><topic>Patients</topic><topic>People and Places</topic><topic>Retrospective Studies</topic><topic>Social Sciences</topic><topic>Statistics</topic><topic>Survival</topic><topic>Taiwan - epidemiology</topic><topic>Tropical diseases</topic><topic>Uses</topic><topic>Utilization</topic><topic>Vaccination</topic><topic>Vector-borne diseases</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Hsuan-Ying</creatorcontrib><creatorcontrib>Yang, Chen-Yi</creatorcontrib><creatorcontrib>Hsieh, Cheng-Yang</creatorcontrib><creatorcontrib>Yeh, Chun-Yin</creatorcontrib><creatorcontrib>Chen, Chang-Chun</creatorcontrib><creatorcontrib>Chen, 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Hsuan-Ying</au><au>Yang, Chen-Yi</au><au>Hsieh, Cheng-Yang</au><au>Yeh, Chun-Yin</au><au>Chen, Chang-Chun</au><au>Chen, Yen-Chin</au><au>Lai, Chung-Chih</au><au>Harris, Rebecca Claire</au><au>Ou, Huang-Tz</au><au>Ko, Nai-Ying</au><au>Ko, Wen-Chien</au><au>Gromowski, Gregory</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>15</volume><issue>9</issue><spage>e0009703</spage><epage>e0009703</epage><pages>e0009703-e0009703</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).
This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients' healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.
This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05).
A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34520457</pmid><doi>10.1371/journal.pntd.0009703</doi><orcidid>https://orcid.org/0000-0002-0164-3468</orcidid><orcidid>https://orcid.org/0000-0002-5475-7848</orcidid><orcidid>https://orcid.org/0000-0002-3007-2537</orcidid><orcidid>https://orcid.org/0000-0001-7497-149X</orcidid><orcidid>https://orcid.org/0000-0001-7353-3383</orcidid><orcidid>https://orcid.org/0000-0002-2636-1520</orcidid><orcidid>https://orcid.org/0000-0002-8772-4073</orcidid><orcidid>https://orcid.org/0000-0003-1110-2582</orcidid><orcidid>https://orcid.org/0000-0003-4422-1596</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2021-09, Vol.15 (9), p.e0009703-e0009703 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
| recordid | cdi_plos_journals_2582585332 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Adults Aged Basal ganglia Biology and Life Sciences Cardiovascular disease Care and treatment Central nervous system diseases Complications Complications and side effects Confidence intervals Convulsions Costs Datasets Delivery of Health Care Dengue fever Diabetes mellitus Diagnosis Disease control Economics Encephalitis Encephalitis, Japanese - economics Encephalitis, Japanese - epidemiology Encephalitis, Japanese - prevention & control Encephalopathy Enzymes Epidemiology Epilepsy Female Health care Health Facilities - economics Health services utilization Health Surveys Humans Immunization Infections Japanese encephalitis Japanese Encephalitis Vaccines - administration & dosage Length of stay Male Medical care Medical care, Cost of Medical prognosis Medical records Medicine and Health Sciences Mental disorders Middle Aged Mortality Movement disorders Neurological complications Ostomy Patients People and Places Retrospective Studies Social Sciences Statistics Survival Taiwan - epidemiology Tropical diseases Uses Utilization Vaccination Vector-borne diseases Young Adult |
| title | Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T06%3A52%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long-term%20neurological%20and%20healthcare%20burden%20of%20adults%20with%20Japanese%20encephalitis:%20A%C2%A0nationwide%C2%A0study%202000-2015&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=Chen,%20Hsuan-Ying&rft.date=2021-09-01&rft.volume=15&rft.issue=9&rft.spage=e0009703&rft.epage=e0009703&rft.pages=e0009703-e0009703&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0009703&rft_dat=%3Cgale_plos_%3EA677985767%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2582585332&rft_id=info:pmid/34520457&rft_galeid=A677985767&rft_doaj_id=oai_doaj_org_article_ac08c06f61d64a2d87b37c5a25a3e193&rfr_iscdi=true |