Rationale: There is estimated 35,700 patients (1.23% of the state’s population) with seizures and epilepsy in Mississippi
1. Despite advances in epilepsy management, disparities in healthcare persist. In 2020, the mean death age in the United States was 73.7 years (74.9 for White and 62.8 for Black people)
2. Previous studies demonstrated that patients with epilepsy die at least one decade earlier than general population
3,4. The objective of this study was to investigate mortality rates and the mean age of death among Mississippians with seizures or epilepsy in relation to their demographics.
Methods: This is a retrospective IRB approved study. We reviewed 10-year data obtained from the electronic health repository available at the University of Mississippi Medical Center and identified 5,732 patients ≥ 18 years of age with the diagnosis of seizures or epilepsy. Age, living status, sex, age of death, insurance presence and type were analyzed. Descriptive statistics were used to summarize patients’ demographics and mortality rates. Two-sample t-test was used to compare means. p value of < 0.05 was considered significant.
Results: Out of 5,732 patients with reported seizures or epilepsy, 3,215 (56.1%) were African American (AA), 2,337 (40.8%) were White (W), 180 (3.1%) were others; 3,268 (57%) were female patients (F), and 2,463 (43%) were male patients (M). The overall mortality rate was 3.91%, significantly higher in African American [143 (4.45%)] than White [73 (3.12%)] patients (p = 0.01; OR 0.443, 95% CI 1.08-1.92).
Mean age of death for all patients was 57.5 years. Among them, 141 (63%) were between ages 18-64, and 83 (37%) between ages 65-96; 115 (51.3%) were F and 109 (48.7%) were M (p=0.08; OR 0.78, 95% CI 0.6-1.03).
The differences in the mean age of death across different sexes and races were not statistically significant, although, AA F had shorter longevity by 5.6 years compared to W M. See Table 1.
In subgroup analyses comparing the mortality rates among different races and sexes, only mortality rate between W F (2.9%) and AA M (4.9%) reached statistical significance at p=0.008 (RR 1.7, 95% CI 1.14-2.43). Although not statistically significant, AA M had a 31% higher risk of death compared to W M (RR 0.7). AA F had 39% higher risk of death compared to W F (RR 1.39).
Of all deceased, 13 (5.8%) had no insurance, 150 (67%) had Medicaid/Medicare, 59 (26.3%) had commercial insurance and 2 (0.9%) had Veterans Affairs insurance. There is no significant difference in the mean age of death between insured (57.6) and non-insured patients (55.5) (p=0.62), nor between patients with Medicaid/Medicare (56.6) and those with private insurance (59.6) (p=0.21).
Conclusions: Our data highlighted shortened life expectancy in Mississippians with epilepsy or seizures, with the longevity being 16 years shorter than the general US population. The mortality rate of AA Mississippians was significantly higher, more so among AA M. Learning about the factors that contribute to these disparities can lead to a development of targeted interventions tailored to specific demographic groups.
Funding: N/A