title: Predictors of poor outcome in patients with posterior reversible encephalopathy syndrome.
abstract: OBJECTIVE
  Posterior reversible encephalopathy syndrome (PRES) is an acute neurotoxic syndrome that, although characteristically reversible, can be fatal or result in long-term disability in a subset of patients. Our aim was to identify factors associated with poor discharge outcome in PRES patients.
  
  
  METHODS
  We retrospectively reviewed the clinical and radiological records of all patients with PRES admitted at our tertiary care medical center from 2007 to 2014. They were divided based their modified Rankin Score at discharge and compared for their baseline variables, clinical, laboratory and imaging features. Poor outcome was defined by a modified Rankin scale 2-6 and was subdivided based on the primary mechanism that led to poor outcome.
  
  
  RESULTS
  Out of 100 PRES subjects, 36% had poor discharge outcomes. Factors associated with poor outcomes on univariate analysis were history of diabetes mellitus, coma, high Charlson comorbidity index, post-transplantation, autoimmune condition, lack of systolic or diastolic hypertension, elevated blood urea nitrogen and involvement of the corpus callosum. On multivariate analysis, only prior diabetes mellitus odd ratio (OR) = 6.8 (95% CI 1.1-42.1, p = 0.04), corpus callosum involvement (OR = 11.7; 95% CI 2.4-57.4, p = 0.00) were associated with poor outcome. Poor outcome also correlated with increased length of hospital stay (OR = 7.9; 95% CI 1.3-49.7, p = 0.03).
  
  
  CONCLUSIONS
  Large prospective studies incorporating serial blood glucose values and advanced imaging studies are required to validate these findings.
authors.affiliation: a Department of Neurology , University of Arkansas for Medical Sciences , Little Rock , AR , US.
authors.forename: Archana
authors.initials: A
authors.lastname: Hinduja
authors.affiliation: b Department of Pediatric Neurology , Arkansas Children Hospital , Little Rock , AR , US.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Habetz
authors.affiliation: c Department of Community Medicine , Dr RP Government Medical College , Tanda , India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Raina
authors.affiliation: d Department of Radiology , University of Arkansas for Medical Sciences , Little Rock , AR , US.
authors.forename: Raghu
authors.initials: R
authors.lastname: Ramakrishnaiah
authors.affiliation: d Department of Radiology , University of Arkansas for Medical Sciences , Little Rock , AR , US.
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests
keywords: PRES; hypertensive encephalopathy; poor outcome; posterior reversible encephalopathy syndrome