Epilepsy in the emergency department: Who needs hospitalization?
Epilepsy in the emergency department: Who needs hospitalization?
Aim: Epilepsy is one of the most common serious chronic neurological diseases, imposing a huge economic burden on the individualand the society. Hospital services have been shown to be the highest direct-cost source for epilepsy patients. Therefore, in our study,we planned to discern the indications of hospitalization and the factors affecting the decision to hospitalize.Material and Methods: Patients admitted to our adult emergency department with epileptic seizures were included in the studybetween February 2017 and September 2018. A total of 111 patients were recorded in terms of demographic data, preferredtransportation method when arriving at the emergency department, anti-epileptic drugs they used, seizure triggers, pre-hospitaltreatments, duration of seizures, and indication, and duration of hospitalization.Results: The rate of status epilepticus was lower in patients receiving a single antiepileptic drug compared to patients receivingtwo antiepileptic drugs and those using three or more antiepileptic drugs. The duration of the hospital stay was longer in patientsreceiving three or more antiepileptic drugs. Single antiepileptic drug users had a lower rate of hospitalization and a lower rate ofintensive care unit admission and pre-hospital ambulance medication.Conclusion: The most significant variable affecting the study’s results was the number of antiepileptic drugs used by the patients.Patients receiving polytherapy should be considered as a special group, and the effects of this situation on both the individual andthe health care system should be examined in more detail.
___
- 1. World Health Organization, Epilepsy: a public health imperative, Publication date: 2019, ISBN: 978-92-4- 151593-1.
- 2. Manjunath R, Paradis PE, Parisé H, et al. Burden of uncontrolled epilepsy in patients requiring an emergency room visit or hospitalization. Neurology 2012;79:1908-16.
- 3. Allers K, Essue BM, Hackett ML, et al. The economic impact of epilepsy: a systematic review. BMC Neurol 2015;15:245
- 4. Kotsopoulos IAW, Evers SMAA, Ament AJHA, et al. The costs of epilepsy in three different populations of patients with epilepsy. Epilepsy Res 2003; 54:131-40.
- 5. Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia 2015;56:1515-23.
- 6. Morgan C, Mike K. Estimated Cost of Inpatient Admissions and Outpatient Appointments for a Population with Epilepsy: A Record Linkage Study. Epilepsia 2004;45:849-54.
- 7. Mostafa A, Rachel E, Laila T. The direct medical costs of epilepsy in children and young people: A populationbased study of health resource utilisation. Epilepsy Res 2014;108: 576-86.
- 8. Jacoby A, Buck D, Baker G, et al. Uptake and costs of care for epilepsy: findings from a U.K. regional study. Epilepsia 1998;39:776-86.
- 9. French JA. Refractory epilepsy: one size does not fit all. Epilepsy Curr 2006;6:177-80.
- 10. Kwan P, Arzimanoglou A, Berg AT, et al. Definition of Drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010;51:1069-77.
- 11. Forsgren I, Beghi E, Ekman M. Cost of epilepsy in Europe. Eur J Neurol 2005;12:54-8.
- 12. Strzelczyk A, Reese JP, Dodel R, et al. Cost of epilepsy: a systematic review. Pharmacoeconomics 2008; 26:463-76.
- 13. Andrade-Machado R, Ochoa-Urrea M, GarciaEspinosa A, et al. Suicidal risk, affective dysphoric disorders, and quality-of-life perception in patients with focal refractory epilepsy. Epilepsy Behav 2015; 45:254-60.
- 14. Garcia ME, Garcia-Morales I, Gil-Nagel A. Prevalence of depressive symptoms and their impact on quality of life in patients with AEI -resistant focal epilepsy (IMDYVA study). Epilepsy Res 2015;110:157-65.
- 15. Strzelczyk A, Griebel C, Lux W, et al. The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal Evaluation of Mortality, Morbidity, Resource Use, and Cost Using German Health Insurance Data. Front Neurol 2017; 8:712.