Authors :
Presenting Author: Najda Robinson-Mayer, LMSW – University of Michigan
Elissa Patterson, PhD – Department of Neurology & Department of Psychiatry – University of Michigan; Isabel O’Sullivan, BA – Department of Neurology – University of Michigan; faith Hobatch, BA – Department of Neurology – University of Michigan; Kyle Darpel, MD – Department of Neurology, – University of Michigan; Palak Patel, MD – Department of Neurology – University of Michigan; gerald Scott Winder, MD – Department of Neurology, Department of Psychiatry and Department of Surgery – University of Michigan; Nicholas Beimer, MD – Department of Neurology & Department of Psychiatry – University of Michigan; Wesley Kerr, MD – Department of Neurology – University of Michigan
Rationale:
This study aims to evaluate the standardized mortality ratio (SMR) of patients in the United States referred to a multidisciplinary clinic for treatment of functional seizures.
Methods:
We identified patients who had or had not died based on automated retrospective review of electronic health records from a registry of patients referred to a single-center multidisciplinary functional seizures treatment clinic. We calculated a SMR by comparing the number of observed deaths to the expected number of deaths in an age, sex, and race matched population within the same state and year records were available.
Results:
A total of 700 patients with functional seizures (mean age 37, 78% female) were followed for 1,328 patient-years for a median of 15 months per patient (interquartile range 6 to 37 months). We observed 10 deaths, corresponding to a mortality rate of 7.5 per 1,000 patient-years and an SMR of 2.2 (95% confidence interval: 1.05-4.06). Four of the eight patients with identified circumstances around their death were in hospice care when they passed. None of the identified causes of death were related to seizures directly.
Conclusions:
These data provide further evidence of elevated mortality in functional seizures soon after diagnosis and referral to treatment, indicating an urgent need for holistic treatment. These data from the decentralized healthcare system of the United States build upon the findings from other countries with large scale health registries.
Funding:
The US National Institute for Neurological Disorders and Stroke (NIH R25NS089450), the American Academy of Neurology, the American Brain Foundation, the Epilepsy Foundation, and the American Epilepsy Society