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Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension

Latif Miah, Huw Strafford, Beata Fonferko-Shadrach, Joe Hollinghurst, Inder M.S. Sawhney, Savvas Hadjikoutis, Mark Rees, Robert Powell, Arron S. Lacey Orcid Logo, Owen Pickrell Orcid Logo

Neurology, Volume: 96, Issue: 8, Pages: e1251 - e1261

Swansea University Authors: Huw Strafford, Beata Fonferko-Shadrach, Joe Hollinghurst, Mark Rees, Robert Powell, Arron S. Lacey Orcid Logo, Owen Pickrell Orcid Logo

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DOI (Published version): 10.1212/wnl.0000000000011463

Abstract

Objective: To characterise trends in incidence, prevalence, and healthcare outcomes in the idiopathic intracranial hypertension (IIH) population in Wales using routinely collected healthcare data.Methods: We used and validated primary and secondary care IIH diagnosis codes within the Secure Anonymis...

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Published in: Neurology
ISSN: 0028-3878 1526-632X
Published: Ovid Technologies (Wolters Kluwer Health) 2021
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Lacey</name><active>true</active><ethesisStudent>true</ethesisStudent></author><author><sid>1c3044b5ff7a6552ff5e8c9e3901c807</sid><ORCID>0000-0003-4396-5657</ORCID><firstname>Owen</firstname><surname>Pickrell</surname><name>Owen Pickrell</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-01-25</date><abstract>Objective: To characterise trends in incidence, prevalence, and healthcare outcomes in the idiopathic intracranial hypertension (IIH) population in Wales using routinely collected healthcare data.Methods: We used and validated primary and secondary care IIH diagnosis codes within the Secure Anonymised Information Linkage databank, to ascertain IIH cases and controls, in a retrospective cohort study between 2003 and 2017. We recorded body mass index (BMI), deprivation quintile, CSF diversion surgery and unscheduled hospital admissions in case and control cohorts.Results: We analysed 35 million patient years of data. There were 1765 cases of IIH in 2017 (85% female). The prevalence and incidence of IIH in 2017 was 76/100,000 and 7.8/100,000/year, a significant increase from 2003 (corresponding figures=12/100,000 and 2.3/100,000/year) (p&lt;0.001). IIH prevalence is associated with increasing BMI and increasing deprivation. The odds ratio for developing IIH in the least deprived quintile compared to the most deprived quintile, adjusted for gender and BMI, was 0.65 (95% CI 0.55 to 0.76). 9% of IIH cases had CSF shunts with less than 0.2% having bariatric surgery. Unscheduled hospital admissions were higher in the IIH cohort compared to controls (rate ratio=5.28, p&lt;0.001) and in individuals with IIH and CSF shunts compared to those without shunts (rate ratio=2.02, p&lt;0.01).Conclusions: IIH incidence and prevalence is increasing considerably, corresponding to population increases in BMI, and is associated with increased deprivation. This has important implications for healthcare professionals and policy makers given the comorbidities, complications and increased healthcare utilization associated with IIH</abstract><type>Journal Article</type><journal>Neurology</journal><volume>96</volume><journalNumber>8</journalNumber><paginationStart>e1251</paginationStart><paginationEnd>e1261</paginationEnd><publisher>Ovid Technologies (Wolters Kluwer Health)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0028-3878</issnPrint><issnElectronic>1526-632X</issnElectronic><keywords>Idiopathic intracranial hypertension, Cohort studies, Prevalence studies, Incidence studies, Quality of life</keywords><publishedDay>23</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-02-23</publishedDate><doi>10.1212/wnl.0000000000011463</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm/><funders>HDRUK</funders><lastEdited>2021-05-24T16:49:14.9173103</lastEdited><Created>2021-01-25T20:04:26.2462993</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Latif</firstname><surname>Miah</surname><order>1</order></author><author><firstname>Huw</firstname><surname>Strafford</surname><order>2</order></author><author><firstname>Beata</firstname><surname>Fonferko-Shadrach</surname><order>3</order></author><author><firstname>Joe</firstname><surname>Hollinghurst</surname><order>4</order></author><author><firstname>Inder M.S.</firstname><surname>Sawhney</surname><order>5</order></author><author><firstname>Savvas</firstname><surname>Hadjikoutis</surname><order>6</order></author><author><firstname>Mark</firstname><surname>Rees</surname><orcid/><order>7</order></author><author><firstname>Robert</firstname><surname>Powell</surname><order>8</order></author><author><firstname>Arron S.</firstname><surname>Lacey</surname><orcid>0000-0001-7983-8073</orcid><order>9</order></author><author><firstname>Owen</firstname><surname>Pickrell</surname><orcid>0000-0003-4396-5657</orcid><order>10</order></author></authors><documents><document><filename>56133__19994__6a219cbdfd904b5fb8d374d55d6cdf9c.pdf</filename><originalFilename>56133.pdf</originalFilename><uploaded>2021-05-24T16:48:23.9115295</uploaded><type>Output</type><contentLength>820416</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright &#xA9; 2021 The Author(s). 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spelling 2021-05-24T16:49:14.9173103 v2 56133 2021-01-25 Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension a6389fc6d4d18e7b67033ee04b381e43 Huw Strafford Huw Strafford true false 7d3f1e80939f2b8fab6a16b5ec6ac845 Beata Fonferko-Shadrach Beata Fonferko-Shadrach true false d7c51b69270b644a11b904629fe56ab0 Joe Hollinghurst Joe Hollinghurst true false 10f39a4e9c2ee00d453cd84c10667ac8 Mark Rees Mark Rees true false 7c8ac48bb6ae4281930e4138f94a51b6 Robert Powell Robert Powell true false 7af5c8bdd1197f85720e4f3d65e803eb 0000-0001-7983-8073 Arron S. Lacey Arron S. Lacey true true 1c3044b5ff7a6552ff5e8c9e3901c807 0000-0003-4396-5657 Owen Pickrell Owen Pickrell true false 2021-01-25 Objective: To characterise trends in incidence, prevalence, and healthcare outcomes in the idiopathic intracranial hypertension (IIH) population in Wales using routinely collected healthcare data.Methods: We used and validated primary and secondary care IIH diagnosis codes within the Secure Anonymised Information Linkage databank, to ascertain IIH cases and controls, in a retrospective cohort study between 2003 and 2017. We recorded body mass index (BMI), deprivation quintile, CSF diversion surgery and unscheduled hospital admissions in case and control cohorts.Results: We analysed 35 million patient years of data. There were 1765 cases of IIH in 2017 (85% female). The prevalence and incidence of IIH in 2017 was 76/100,000 and 7.8/100,000/year, a significant increase from 2003 (corresponding figures=12/100,000 and 2.3/100,000/year) (p<0.001). IIH prevalence is associated with increasing BMI and increasing deprivation. The odds ratio for developing IIH in the least deprived quintile compared to the most deprived quintile, adjusted for gender and BMI, was 0.65 (95% CI 0.55 to 0.76). 9% of IIH cases had CSF shunts with less than 0.2% having bariatric surgery. Unscheduled hospital admissions were higher in the IIH cohort compared to controls (rate ratio=5.28, p<0.001) and in individuals with IIH and CSF shunts compared to those without shunts (rate ratio=2.02, p<0.01).Conclusions: IIH incidence and prevalence is increasing considerably, corresponding to population increases in BMI, and is associated with increased deprivation. This has important implications for healthcare professionals and policy makers given the comorbidities, complications and increased healthcare utilization associated with IIH Journal Article Neurology 96 8 e1251 e1261 Ovid Technologies (Wolters Kluwer Health) 0028-3878 1526-632X Idiopathic intracranial hypertension, Cohort studies, Prevalence studies, Incidence studies, Quality of life 23 2 2021 2021-02-23 10.1212/wnl.0000000000011463 COLLEGE NANME COLLEGE CODE Swansea University HDRUK 2021-05-24T16:49:14.9173103 2021-01-25T20:04:26.2462993 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Latif Miah 1 Huw Strafford 2 Beata Fonferko-Shadrach 3 Joe Hollinghurst 4 Inder M.S. Sawhney 5 Savvas Hadjikoutis 6 Mark Rees 7 Robert Powell 8 Arron S. Lacey 0000-0001-7983-8073 9 Owen Pickrell 0000-0003-4396-5657 10 56133__19994__6a219cbdfd904b5fb8d374d55d6cdf9c.pdf 56133.pdf 2021-05-24T16:48:23.9115295 Output 820416 application/pdf Version of Record true Copyright © 2021 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY) true eng http://creativecommons.org/licenses/by/4.0/
title Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension
spellingShingle Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension
Huw Strafford
Beata Fonferko-Shadrach
Joe Hollinghurst
Mark Rees
Robert Powell
Arron S. Lacey
Owen Pickrell
title_short Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension
title_full Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension
title_fullStr Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension
title_full_unstemmed Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension
title_sort Incidence, Prevalence, and Health Care Outcomes in Idiopathic Intracranial Hypertension
author_id_str_mv a6389fc6d4d18e7b67033ee04b381e43
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1c3044b5ff7a6552ff5e8c9e3901c807
author_id_fullname_str_mv a6389fc6d4d18e7b67033ee04b381e43_***_Huw Strafford
7d3f1e80939f2b8fab6a16b5ec6ac845_***_Beata Fonferko-Shadrach
d7c51b69270b644a11b904629fe56ab0_***_Joe Hollinghurst
10f39a4e9c2ee00d453cd84c10667ac8_***_Mark Rees
7c8ac48bb6ae4281930e4138f94a51b6_***_Robert Powell
7af5c8bdd1197f85720e4f3d65e803eb_***_Arron S. Lacey
1c3044b5ff7a6552ff5e8c9e3901c807_***_Owen Pickrell
author Huw Strafford
Beata Fonferko-Shadrach
Joe Hollinghurst
Mark Rees
Robert Powell
Arron S. Lacey
Owen Pickrell
author2 Latif Miah
Huw Strafford
Beata Fonferko-Shadrach
Joe Hollinghurst
Inder M.S. Sawhney
Savvas Hadjikoutis
Mark Rees
Robert Powell
Arron S. Lacey
Owen Pickrell
format Journal article
container_title Neurology
container_volume 96
container_issue 8
container_start_page e1251
publishDate 2021
institution Swansea University
issn 0028-3878
1526-632X
doi_str_mv 10.1212/wnl.0000000000011463
publisher Ovid Technologies (Wolters Kluwer Health)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Objective: To characterise trends in incidence, prevalence, and healthcare outcomes in the idiopathic intracranial hypertension (IIH) population in Wales using routinely collected healthcare data.Methods: We used and validated primary and secondary care IIH diagnosis codes within the Secure Anonymised Information Linkage databank, to ascertain IIH cases and controls, in a retrospective cohort study between 2003 and 2017. We recorded body mass index (BMI), deprivation quintile, CSF diversion surgery and unscheduled hospital admissions in case and control cohorts.Results: We analysed 35 million patient years of data. There were 1765 cases of IIH in 2017 (85% female). The prevalence and incidence of IIH in 2017 was 76/100,000 and 7.8/100,000/year, a significant increase from 2003 (corresponding figures=12/100,000 and 2.3/100,000/year) (p<0.001). IIH prevalence is associated with increasing BMI and increasing deprivation. The odds ratio for developing IIH in the least deprived quintile compared to the most deprived quintile, adjusted for gender and BMI, was 0.65 (95% CI 0.55 to 0.76). 9% of IIH cases had CSF shunts with less than 0.2% having bariatric surgery. Unscheduled hospital admissions were higher in the IIH cohort compared to controls (rate ratio=5.28, p<0.001) and in individuals with IIH and CSF shunts compared to those without shunts (rate ratio=2.02, p<0.01).Conclusions: IIH incidence and prevalence is increasing considerably, corresponding to population increases in BMI, and is associated with increased deprivation. This has important implications for healthcare professionals and policy makers given the comorbidities, complications and increased healthcare utilization associated with IIH
published_date 2021-02-23T04:10:51Z
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