Incidence and mortality of brain abscess in Denmark: A nationwide population-based study.
Clin Microbiol Infect. 2019 May 31;:
Authors: Bodilsen J, Dalager-Pedersen M, van de Beek D, Brouwer MC, Nielsen H
OBJECTIVE: To examine the incidence and mortality of brain abscess.
METHODS: We accessed nationwide population-based medical registries to obtain data for patients with first-time brain abscess in Denmark from 1982 through 2016. Annual age- and sex-standardised incidence rates with 95% confidence intervals (95% CIs) were calculated and compared by direct standardisation. We used Cox regression to compute mortality rate ratios adjusted for age and year groups, sex, and Charlson comorbidity index score (CCI).
RESULTS: We identified 1,384 patients (37% females). The overall standardised incidence rate of brain abscess was 0.76 per 100,000 person years (95% CI 0.70-0.81). The incidence rates gradually increased from 0.60 during 1982-88 to 0.90 per 100,000 person years during 2010-16 yielding an incidence rate ratio of 1.50 (95% CI 1.26-1.79). This increase in incidence was most pronounced in the proportions of brain abscess patients >40 years of age and those with immuno-compromise. The 1-year mortality declined from 29% during 1982-88 to 20% during 2010-16 yielding an adjusted mortality rate ratio of 0.44 (95% CI 0.31-0.63). Risk factors for death were advanced age, CCI >0, immuno-compromise, and congenital heart disease.
CONCLUSIONS: The incidence of brain abscess in Denmark is low but increasing, especially in the elderly, along with an increasing proportion of brain abscess patients with immuno-compromise. The prognosis has improved during the last decades but mortality remains high and risk factors for death in our study are advanced age, presence of comorbidity, immuno-compromise, and congenital heart disease.
PMID: 31158518 [PubMed – as supplied by publisher]