Phenome-Wide Association Study Shows Similar Long-Term Outcomes of Infantile Spasms Patients Following Prednisolone Versus Adrenocorticotropic Hormone Treatment
Abstract number :
2.122
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2021
Submission ID :
1825509
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:44 AM
Authors :
Monika Baker, BS - University of Utah; Joshua Bonkowsky, MD, PhD - Division Chief, Pediatric Neurology, Primary Children's Hospital; Clinton Mason, PhD - Assistant Professor, Pediatrics, University of Utah; David Sant, PhD - Staff Scientist, Noorda College of Osteopathic Medicine; Matthew Sweney, MS, MD - Pediatric Epileptologist, Pediatric Neurology, Primary Children's Hospital; Jacob Wilkes, BS - Outcomes Analyst, Intermountain Healthcare
Rationale: Infantile spasms (IS) is a severe pediatric epilepsy disorder typically presenting in the first year of life. Patients are at risk for adverse long-term outcomes, including increased mortality, risk for intractable epilepsy, and neurodevelopmental impairment. Determination of treatment guidelines for infantile spasms (IS) has been controversial, and some key aspects remain unresolved. There is conflicting and insufficient data on the outcomes of patients with IS when treated with adrenocorticotropic hormone (ACTH) vs prednisolone/prednisone (PRED).
Methods: A retrospective, case-control study using the Pediatric Hospital Information Systems (PHIS) database was performed over 10 years. Outcomes, defined as hospital discharge diagnoses, were followed for each patient for up to five years following IS diagnosis. Patients with an ICD9 diagnosis of IS treated with either ACTH or PRED were identified, and propensity score matching was performed to establish the final cohorts. Outcomes were analyzed for phecodes, which are groups of similar ICD9 conditions.
Results: 5955 IS patients were identified; following matching, comparisons and analyses were subsequently performed for 286 patients each in the ACTH and PRED groups (572 total). Following Bonferroni correction for multiple statistical comparisons, only two, non-neurological phecodes, Viral Infection and Respiratory Failure, were more common in the PRED cohort (p < 2.2026e-04). These two phecodes were also more common using an exact matching analysis (p < 0.05).
Clinical Epilepsy