Abstracts

Rationale: Prior research has shown that incident epilepsy patients have mortality rates significantly higher than the general population, with up to 15% of patients dying within 5 years of diagnosis (Epilepsia 1980; 21(4): 399-412). It is likely that patient demographics play an important role in patient mortality and epilepsy control. Understanding the demographics and survival rates of incident epilepsy cases has major implications in referral patterns and treatment options, and may allow for prediction of patient risk. In this study, we analyzed the demographics of a cohort of patients with incident epilepsy and examined relationships with five-year survival data in order to better understand the incident epilepsy patient population and to identify factors that influence patient outcomes. Methods: Criteria for inclusion in this cohort were one or more visits with an epilepsy diagnosis (ICD-9 345.XX) during 2012-2013, or two seizure events (ICD-9 780.3X). Data on ethnicity, sex, employment status, marital status, and insurance status was analyzed to give a demographic profile of the patient population. Patients were followed for five years after their initial diagnosis to obtain additional data including epilepsy etiology and 5-year survival rates. We utilized t-tests and chi-squared tests to identify associations between demographic and etiological factors and 5-year survival rates. These observations will inform the planned multivariable modeling analysis. Results: The patient population was generally white, single, and equally distributed between men and women. Approximately half of the population was covered by Medicare or Medicaid, with the majority of the remainder covered under private insurance. Over 80% of these patients survived out to five years after their initial diagnosis, and 64% were able to bring their epilepsy under control. The patients who were deceased within 5-years were older, with a median age of 66 at diagnosis, compared to age 30 for the survivors. Factors associated with death (all p<0.01), included male sex and seizure etiology (specifically encephalomalacia/previous stroke or hemorrhage, and tumors). Seizure control at 5-years was not significantly related to survival. Conclusions: Knowledge of demographic factors which correlate strongly with mortality of epilepsy patients is a valuable tool for identifying at-risk patient populations which may need additional intervention and monitoring. Eventually, this data could even be used to develop preventative programs tailored for populations with increased risk of mortality. Funding: This project is funded by CDC SIP18-001.