Disparity in Rates of Epilepsy Surgery in Incarcerated Epilepsy Patients Compared with Free-world Epilepsy Patients
Abstract number :
2.055
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2024
Submission ID :
318
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Nhu Nguyen, BS – University of Texas Medical Branch
Julie Roth, MD – Warren Alpert Medical School of Brown University
Kara Stavros, MD – Warren Alpert Medical School of Brown University
Todd Masel, MD, MBA – University of Texas Medical Branch
Patrick Karas, MD – University of Texas Medical Branch
Peter Kan, MD, MPH – University of Texas Medical Branch
Presenting Author: Audrey Nath, MD, PhD – University of Texas Medical Branch
Rationale: Incarcerated individuals represent a marginalized population who experience a disproportionate burden of neurological diseases including status epilepticus (SE), a neurological emergency characterized by prolonged seizures. Patients with medically-refractory epilepsy are at higher risk for SE, and epilepsy surgery can be an effective treatment for these patients. We hypothesize that there are higher rates of SE and lower rates of epilepsy surgery utilization among incarcerated versus free-world patients with epilepsy.
Methods: Data was drawn from the Clarity database of electronic medical records in Epic for the patients within the Texas Department of Criminal Justice (TDCJ) system and free-world patients at University of Texas Medical Branch (UTMB) from 2004-2013. A z-test for two population proportions was used to compare the prevalence of SE and epilepsy surgery.
Results: Of the 3,110 patients in the TDCJ system with epilepsy, 0.29% had SE and 0.19% had undergone epilepsy surgery. Of the 13,585 patients in the free-world population with epilepsy, 0.41% had SE and 0.68% had undergone epilepsy surgery. There was no significant difference (z = -0.99, p = 0.32) in the proportions of patients who had SE. However, there was a statistically significant difference (z = -3.2, p = 0.001) in the proportions of patients who had undergone epilepsy surgery between the two populations.
Conclusions: Incarcerated patients with epilepsy represent a marginalized population. Within this population, there is a disparity in epilepsy surgery utilization as compared with free-world populations. The similar prevalence of SE between the incarcerated and free-world populations suggests a similar degree of seizure burden between both groups of epilepsy patients.
Funding: This study was conducted with the support of the Institute for Translational Sciences at the University of Texas Medical Branch, supported in part by a Clinical and Translational Science Award (UL1 TR001439) from the National Center for Advancing Translational Sciences, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Health Services (Delivery of Care, Access to Care, Health Care Models)