Abstracts

Rationale: More than 3 million people in USA have epilepsy [1]. In spite of availability of several new and effective treatments, significant number of patients continue to have uncontrolled seizures, sometimes requiring hospitalizations. We examined the prevalence of hospitalizations due to uncontrolled epilepsy in the US community population.Methods: We examined the prevalence of all hospitalizations with uncontrolled epilepsy (defined as hospitalizations with a primary diagnosis of ICD9 codes 345.xx (epilepsy and recurrent seizures) or 780.39 (other convulsions)) in the US community population aged 18 years or older in 2012 using the Nationwide Inpatient Sample (NIS) data. NIS is a stratified random sample of all US community hospitals. It is the largest inpatient care database with information on all inpatient care regardless of insurance status. Prior studies have demonstrated a positive predictive value (PPV) for a diagnosis of epilepsy of 98.9% for ICD 9 code 345.xx, and a PPV of 84% for 780.39 [2,3]. Prevalence was calculated per 100,000 US population. US population data was taken from US census bureau.Results: In 2012, there were 30.7 million all-cause hospitalizations in US adult patients. Of these, 223,105 were due to a primary diagnosis of epilepsy (159,740 due to primary diagnosis of 345.xx and 63,365 with a primary diagnosis of ICD9 code 780.39). The community prevalence of hospitalizations for uncontrolled epilepsy in adults was 93/100,000 population. The prevalence increased with age, reaching 196 per 100,000 in the extreme elderly (age 85 years or more) (Table 1). Uncontrolled epilepsy hospitalizations accounted for a total of 825,332 hospitalization-days (average per hospitalization 3.7 days). A large percentage of these hospitalizations (78.5%) were admitted directly from emergency departments. The case-fatality rate was 0.7%, resulting in 1,600 epilepsy-related deaths in 2012. The average charges per hospitalization were $30,952 and the total charges were over $ 6.9 billion (Table 1). Medicare and Medicaid paid for 61% of all uncontrolled epilepsy hospitalizations.Conclusions: National US population-level data suggested that uncontrolled epilepsy was associated with 223,105 hospitalizations and 1,600 deaths in 2012, and total hospital charges of over $ 6.9 billion dollars. While several new treatments for epilepsy have been introduced in recent years, significant numbers of epilepsy patients are still admitted to a hospital for control of their seizures, with large health care clinical and economic consequences. Aggressive seizure control in outpatient management remains critically important for epilepsy patients. Development of novel anti-epileptics that enable efficient seizure control would be highly desirable.