Abstract Details

Title National estimate of incidence and predictors of generalized convulsive status epilepticus following traumatic brain injury (TBI) using Nationwide inpatient sample database.(2011-2014)

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P9 - Poster Session 9 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-004

Objective To evaluate the incidence and predictors of generalized convulsive status epilepticus following traumatic brain injury.

Background Traumatic brain injury (TBI) associated Status epilepticus may be under recognized and is associated with significant mortality and morbidity. Objective of our study was to evaluate outcomes and predictors of generalized convulsive status epilepticus (GCSE) following traumatic brain injury.

Design/Methods Nationwide Inpatient Sample (NIS) from 2011 to 2014 was utilized to identify patient with TBI using HCUP CCS code 233 in primary diagnosis field and GCSE using ICD 9 CM code 345.3 in secondary diagnosis field. Differences between categorical variables were tested using the chi-square test and continuous variables using the Student t-test. Hierarchical 2 level logistic regression model was used to evaluate predictors of GCSE following TBI.

Results

We identified 609,372 hospitalization with primary diagnosis of TBI during our study period, of which 2,510 (0.4%) admissions were associated with GCSE (Mean age 64.1 ± 18.1 years, 59.8% male, 72.7% Caucasian). GCSE-TBI group was associated with higher mortality (32.9% vs 8.7%), longer mean length of stay (LOS) (16.9 vs 6.1 days) and higher mean cost of hospitalization (57,758$ vs 19,298 $) as compared to Non-GCSE group. CNS infections (OR:5.17, 95% CI:3.03-8.82, p<0.001), Acute ischemic stroke (OR:3.60, 95% CI:2.50-5.18, p<0.001), Anoxic brain injury (OR:5.29, 95% CI:3.37-8.30, p<0.001), Diabetes mellitus (OR:1.43, 95% CI:1.15-1.76, p=0.001) and Fluid and electrolyte imbalance (OR:3.24, 95% CI:2.69-3.90, p<0.001) were predictors of GCSE in TBI patients. Female gender (OR:0.77, 95% CI:0.64-0.94, p=0.01), Private insurance (OR:0.53, 95% CI:0.41-0.70, p<0.001) and self-payment (OR:0.52, 95% CI:0.37-0.73, p<0.001) were negative predictors of GCSE.

Conclusions Generalized convulsive status epilepticus is associated with worse outcomes suggested by higher in-hospital mortality, prolonged LOS and higher cost of hospitalization. Anoxic brain injury, Acute ischemic stroke and CNS infection were strong predictors of GCSE.

Authors/Disclosures
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology) PRESENTER	Dr. Singh has nothing to disclose.
Neena Viswanathan, MD	Dr. Viswanathan has nothing to disclose.
Parisha Bhatia, MD	Dr. Bhatia has nothing to disclose.
Varun Kumar, MD (Arrive Streeterville)	Dr. Kumar has nothing to disclose.
	No disclosure on file
	No disclosure on file
Chirag N. Savani, MD (Tampa General Hospital)	No disclosure on file

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