麻豆传媒

Hospitalization for status epilepticus seizures rose from 2010 to 2019, disproportionately affecting Black patients, U.S. inpatient data showed.

The overall prevalence of status epilepticus hospitalizations more than doubled in that period, reported Gabriela Tantillo, MD, MPH, of Baylor College of Medicine in Houston.

Prevalence per 10,000 hospital admissions was 27.3 for Black patients, 15.8 for Hispanic patients, 13.7 for white patients, and 16.1 for patients in other racial or ethnic groups (P<0.01), Tantillo said in a presentation at the American Epilepsy Society annual meeting.

Status epilepticus involves prolonged, life-threatening seizures and is associated with high rates of morbidity and mortality.

Several factors may have led to the overall increase in hospitalization for status epilepticus, Tantillo observed. "One of them was a change in the definition of status from 30 minutes of continuous seizure activity to 5 minutes that might be reducing the duration required for diagnosis," she told 麻豆传媒.

"We know there's been increasing use of EEG [electroencephalogram] monitoring in intensive care units, also leading to potentially increased diagnoses," Tantillo continued. "There also was a change in coding in the middle of the study period from ICD-9 to ICD-10, which may be playing a role."

"Ultimately, though, we cannot definitively rule out that there is a change in the underlying incidence of status itself, but there are numerous factors that may have led the rates to go up without the true incidence of the disease process itself increasing," she said.

Tantillo and colleagues analyzed diagnostic codes for status epilepticus among 486,861 hospitalizations from 2010 to 2019 in the , an all-payer inpatient care database.

Most hospitalizations for status epilepticus (71.3%) were at teaching hospitals. Prevalence of status epilepticus was highest for people in the lowest versus the highest income quartile (P<0.01).

Black patients were more likely to have a tracheostomy (adjusted OR 1.71, 95% CI 1.57-1.86) or gastrostomy (adjusted OR 1.78, 95% CI 1.65-1.92) compared with white patients, a possible indicator of severe status epilepticus or of underlying medical injury, Tantillo noted.

The odds of receiving EEG monitoring rose with income (OR 1.47, 95% CI 1.34-1.62 for the highest income quartile) and were higher in urban teaching hospitals than in rural hospitals (OR 12.72, 95% CI 8.92-18.14).

Mortality odds were lower in Hispanic (OR 0.82, 95% CI 0.76-0.89) and Black patients (OR 0.71, 95% CI 0.67-0.75) versus white patients. "One potential reason might be that the underlying cause of status epilepticus might differ among minority groups," said Tantillo.

"For example, status epilepticus related to low anti-seizure medication levels are associated with better survival than other causes, such as a catastrophic brain bleed or lack of oxygen to the brain," she added.

Older adults and people with lower socioeconomic status had higher odds of status epilepticus mortality.

The study had limited data about specific factors that may have caused seizures. "Our study did not look at the underlying causes of status epilepticus," Tantillo noted. "We just looked at the diagnosis. More research is ultimately needed for us to understand why there is this disparity."

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