Nationwide Analysis of In-Hospital Mortality in Patients with Encephalitis-Related Diagnoses in Ecuador

Encephalitis and related acute encephalopathic syndromes represent severe neurological conditions with diverse etiologies and variable clinical outcomes. This study aimed to analyze nationwide hospitalization patterns for encephalitis-related diagnoses in Ecuador between 2018 and 2024.

We used data from the Ecuadorian National Institute of Statistics and Census to estimate age-adjusted hospitalization and mortality rates according to ICD-10 codes. Binary and multinomial logistic regression models were employed to identify sociodemographic factors and diagnostic categories of encephalitis associated with hospitalization and in-hospital mortality.

A total of 1560 hospitalizations related to encephalitis-spectrum diagnoses were recorded, with an overall age-adjusted rate of 0.127 per 100,000 inhabitants and 6.0% in-hospital mortality. Unspecified encephalitis and encephalomyelitis were the most common diagnostic categories. Adolescents (10-19 years) were more frequently diagnosed with acute disseminated and bacterial meningoencephalitis, while patients aged ≥70 had higher odds of "other" encephalitis subtypes and the highest mortality risk (aOR = 0.265; 95% CI: 0.116-0.608). Indigenous individuals were more likely to be diagnosed with acute disseminated encephalitis, and Black individuals showed a higher risk for myelopathy associated with human T-cell lymphotropic virus type 1-associated myelopathy.

Age and ethnicity significantly influence hospitalization due to encephalitis-related diagnoses in Ecuador. These findings provide epidemiological rates for a lower-middle-income country where the lack of precise diagnosis, age, and ethnicity contribute to the vulnerability of encephalitis.