Abstracts

Rationale: : Epilepsy is a critical neurological disorder, affecting approximately 0.5 to 2% of the United States population. Refractory epilepsy is a complex medical syndrome, that has multiple burdens, including co morbidities, frequent emergency department (ED) admissions, and hospitalizations related to seizures, or complications of seizures. This also poses a big economical burden with studies showing direct medical costs ranging from $1,620 to $52,558 annually. The majority of this cost is related to ED and hospitalization cost. The Ketogenic diet (KGD) has been a well established effective treatment for patients with refractory epilepsy. This study intends to assess the impact of the KGD in children with pharmacologically refractory epilepsy to reduce emergency room visits, and hospital admissions related to epilepsy. Methods: This is a retrospective chart review study, in a tertiary level IV pediatric epilepsy center, where the data from 123 patients out of 142 consecutive patients started on the KGD was analyzed for the number of ED admissions, hospitalizations, as well as number of hospital days up to 12 months prior to starting a KGD, and up to 12 months after the KGD was started. This included the hospitalization required for the KGD initiation.Results: Out of 123 patients, 72 were males, and 51 females, between the ages of 0.3 and 17 years, with an average age of 4.4 years at the time of initiation of KDG. 93 patients were admitted to the hospital for diet initiation, with total of 292 days spent in the hospital. 12 months after the KGD initiation, the total number of ED visits was reduced by 62%, number of hospital admissions was reduced by 51%, and total number of hospital days was reduced by 39% when compared to 12 months before the KGD initiation. Table 1Conclusions: This study demonstrates that the Ketogenic diet has positive impact in reducing the number of ED visits, and numbers of hospitalizations, as well as length of hospital stay related to seizures, and associated comorbidities. There is an initial increase in hospital stay related to the KGD initiation, however this was shown to continue to decrease as patients stayed on the ketogenic diet.