Abstract Details

Title Increased Mortality in Elderly Veterans Diagnosed with Epilepsy

Topic Epilepsy

Presentation(s) P03 - (-)

Poster/Presentation
Number 117

Objective

Background BACKGROUND: Individuals with epilepsy have elevated mortality, the extent of which is influenced by a variety of factors including age, geographic location, etiology, seizure type & severity, medication burden and comorbid conditions. There is a paucity of population based studies examining this relationship, especially in elderly patients, who represent the fastest growing segment of general population and have an increased incidence of new onset epilepsy. Data from the Department of Veterans Affairs (VA) offer a unique opportunity to evaluate the relationship between epilepsy and mortality in a defined elderly population.

Design/Methods DESIGN/METHODS: We used VA administrative data (1999-2004) to identify veterans 66+ years with newly-diagnosed epilepsy using a validated algorithm. We identified patient demographics, Charlson cormorbidity index, medication burden and adherence, and diagnosis source (neurology, primary care, ER, hospital). The primary outcome, mortality, was identified one and three years after diagnosis.

Results RESULTS: 6373 patients, aged 66 yrs and older, were identified with a new diagnosis of epilepsy. Within this population, mortality was 12% at one year and 32.9% within 3 years. Mortality at 3 years was strongly associated with age (85+ OR 1.98 (1.66-2.37), source of diagnosis (ER; OR 1.45; 1.25-1.68; hospital OR 1.49; 1.30-1.70) and Charlson index (OR 1.11; 1.10-1.13). High medication adherence was associated with reduced odds of mortality (OR 0.58; .53-.63). Findings were similar for one-year mortality.

Conclusions CONCLUSIONS: As expected in elderly patients with newly-diagnosed epilepsy disease burden and age were associated with higher mortality and high medication adherence was associated with lower mortality. There is a strong effect of initial source of diagnosis suggesting other factors (e.g., comorbid conditions, disease severity) may influence the outcome.

Authors/Disclosures
Perry Foreman, MD, PhD (Sandra and Malcolm Berman Brain & Spine Institute) PRESENTER	No disclosure on file
Anne C. Van Cott, MD, FAAN (VA Pittsburgh Healthcare System/University of Pittsburgh)	Dr. Van Cott has nothing to disclose.
Mary Jo Pugh, PhD, RN, FAAN	The institution of Dr. Pugh has received research support from Department of Defense, Epilepsy Research Program. The institution of Dr. Pugh has received research support from VA Health Services Research and Development Service. The institution of Dr. Pugh has received research support from VA Rehabilitation Research and Development Service. The institution of Dr. Pugh has received research support from Congressionally Directed Research Programs.
Nancy M. Nealon, MD (Cornell Medical Center)	Dr. Nealon has nothing to disclose.

��ɫ��

��ɫ��