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Abstract Details

Racial Disparity in the Development of Seizure as a Delayed Complication of Subdural Hematoma
Neuro Trauma, Critical Care, and Sports Neurology
P2 - Poster Session 2 (5:30 PM-6:30 PM)
4-078

Using administrative claims data from a statewide population, we tested the hypothesis that black race is associated with seizures after subdural hematoma (SDH).
Seizures are a well-known complication of SDH, occurring in an estimated 43% of patients. Black patients have been found to have increased risk for post-traumatic epilepsy and status epilepticus during SDH admission, but these associations remain poorly understood.
Using claims data on all discharges from emergency departments (ED) and acute care hospitals in California, we identified adult (age>18) patients admitted between 2005 and 2011 with first time SDH. Patients without longitudinal identifiers and non-California residents were excluded. We used validated diagnosis codes to identify a primary outcome of ED or hospital revisit for seizure. We then used Cox regression for survival analysis to identify demographic and medical risk factors for seizure revisit.
We identified 34,383 survivors of SDH (mean age 71.4 [SD 16.4], female sex 14,157 [41.5%]). 3,883 (11.3%) patients had revisit for seizure during the study period. Black patients (n=1,931 [5.9%]) had significantly increased risk of seizure following hospitalization for SDH (HR 1.42, CI 1.28-1.59, p<0.001). Alcohol use, liver disease, and renal disease were also independently associated with seizure revisit (HR 1.42, CI 1.29-1.56, p<0.001; HR 1.27, CI 1.08-1.49, p=0.005; and HR 1.46, CI 1.32-1.62, p<0.001; respectively). Status epilepticus during SDH admission, though infrequent (n=112 [0.3%]), was associated with a three-fold risk of seizure revisit (HR 3.09, CI 2.39-4.00, p<0.001). Racial differences persisted when patients with a diagnosis of seizure or epilepsy during or before SDH admission were excluded in secondary analysis.
We found an association between black race and a heightened risk of seizure after SDH.
Authors/Disclosures
Stacy C. Brown, MD (The Queen's Medical Center, Neuroscience Institute)
PRESENTER 		Dr. Brown has nothing to disclose.
Zachary King (Yale) No disclosure on file
Lindsey R. Kuohn, MD Dr. Kuohn has nothing to disclose.
Hooman Kamel, MD (Weill Cornell Medical College) Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.
Emily J. Gilmore, MD (Yale University School of Medicine) Dr. Gilmore has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for carpl.ai. Dr. Gilmore has received personal compensation in the range of $0-$499 for serving as a Consultant for AAN. Dr. Gilmore has received research support from NIH.
Jennifer A. Frontera, MD (NYU Langone Health) Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving as a Consultant for FirstKindMedical. Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Physician 好色先生 Resource. The institution of Dr. Frontera has received research support from NIH. The institution of Dr. Frontera has received research support from Alexion. Dr. Frontera has received publishing royalties from a publication relating to health care.
Guido J. Falcone, MD (Yale School of Medicine) The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
Kevin N. Sheth, MD, FAAN (Yale UniversityDivision of Neuro and Critical Care) Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.