Abstract Details

Title Temporal Trends & Outcomes Of Hospitalizations For Epilepsy With Aneurysmal Subarachnoid hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S6 - Cerebrovascular Disease: Diagnosis, Prediction, and Population Health (3:42 PM-3:54 PM)

Poster/Presentation
Number 002

Objective To evaluate national estimate of trends and outcomes of epilepsy in aneurysmal subarachnoid hemorrhage (aSAH).

Background Epilepsy is well known complication following aSAH , but data regarding incidence of epilepsy in this population is sparse.

Design/Methods Nationwide Inpatient Sample (NIS) 2010-2014 utilized ICD-9 codes. Included patients ≥ 18 years, Excluded Traumatic aSAH and arteriovenous malformations. Hospitalization with Epilepsy identified using ICD-9CM code 345.xx in secondary diagnostic field, differences between categorical variables were tested using chi-square test and continuous variables using Student t-test. P values for trends were generated by Cochrane-Armitage test for categorical variables & simple linear regression for continuous variables.

Results Of 41,912 patients, 1,655 (4%) had incidence of epilepsy(Mean age 54.5 ± 15 years, 69.1% Female). aSAH-epilepsy group was associated with significantly higher incidence of comorbidities like CHF (9.9 % vs 5.2%), coagulopathy (10.6% vs 6%), Cerebral edema (32.5 % vs 24.3%) & complications such as neurological (35.9% vs 32.5%), Pulmonary (65.2% vs 48.2%), hematologic (43.6% vs 28.4%), & infectious (51.9% vs 37.4%). aSAH-epilepsy group were associated with Medicare/Medicaid insurance (51.3%) & at a teaching hospital (86.1%) (p <0.0001). In-hospital mortality with aSAH-epilepsy was 17.2 % vs 10.9% %, longer mean length of stay (23.9 vs 18.1 days, p <0.0001) & higher mean cost of hospitalization (112691$ vs 85987$, p <0.0001). Hospitalization for aSAH epilepsy increased from 3.8 % to 4.5 % in 2014 with upward trends in-hospital mortality (16.6% to 21.7%), mean length of stay (23.1 days to 24.3 days) & mean cost of hospitalization (from 101945 $ to 121,827 $ in 2014, p <0.0001). Multivariate analysis showed increased odds of mortality (OR:1.72, p=0.002) & longer length of stay (OR:2.31, p=0.0002).

Conclusions There was higher upward trends in incidence of epilepsy during aSAH with higher in hospital mortality, longer length of stay & higher cost of hospitalization. It is imperative to consider that comorbid conditions lead to higher in-hospital complications.

Authors/Disclosures
Parisha Bhatia, MD PRESENTER	Dr. Bhatia has nothing to disclose.
	No disclosure on file
Neena Viswanathan, MD (Bluesky)	Dr. Viswanathan has nothing to disclose.
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology)	Dr. Singh has nothing to disclose.
	No disclosure on file

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