We wanted to study the recent trends in its utilization, important predictors and the effect of hospital characteristics.

We performed a cross-sectional analysis using the Nationwide Inpatient Sample (NIS), 2008–2014, of US adult hospitalizations with medically refractory localized epilepsy  identified (primary or secondary diagnosis code 345.41 or 345.51) and divided the cohort into those who did or did not receive lobectomy/partial lobectomy (procedure code 01.53).  Annual rate of lobectomy/partial lobectomy use was calculated using NIS weighting. Potential factors associated with increased likelihood of lobectomy/partial lobectomy were assessed using logistic regression.

Weighted data revealed 77,599 hospitalizations for medically refractory focal epilepsy and 3,123 lobectomy/partial lobectomy from 2009 to 2014. Mean age of the surgery cohort was 30.9 ± 17.1 years and 51.9%  were females. Across 2009–2014, 4.2% of  patients received surgeries; with a downward trend from 2009 (5.29%) to 2014 (3.08%): p <0.356. Whites were more likely to have surgery than racial minorities (relative risk [RR], 1.34; 95% confidence interval [CI], 1.06–1.69), teaching hospitals were more likely (RR, 6.56; 95%CI,2.59–16.6) than non-teaching hospitals and privately insured individuals were more likely to receive lobectomy than those with Medicaid, Medicare, Self-pay or other (RR,1.71;95%CI,1.45–2.01). There was no statistically significant difference in the performance of  lobectomies/partial lobectomies between different hospital sizes (small, medium and large)  (3.02%, 3.31%, 4.28%: p = 0.18 respectively).