Seizure frequency, healthcare resource utilisation and mortality in childhood epilepsy: a retrospective cohort study using the THIN database. Issue 11 (4th July 2019)

• Record Type: Journal Article
• Authors: Myland, Melissa; Buysse, Brian; Tsong, Wan; Power, G Sarah; Nordli, Douglas; Chin, Richard F M
• Is Part Of: Archives of disease in childhood. Volume 104:Issue 11(2019)
• Page Start: 1070
• Page End: 1076
• Publication Date: 2019-07-04
• Subjects: epidemiology -- neurology -- paediatric practice; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-316910
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Objective: To understand the association of seizure frequency with healthcare resource utilisation (HCRU) and mortality in UK children with epilepsy (CWE). Design: Retrospective cohort study. Setting: Routinely collected data in primary care from The Health Improvement Network UK database. Patients: CWE ≥1 and<18 years of age with a record of seizure frequency were included in mortality analyses from 2005 to 2015 and HCRU analyses from 2010 to 2015. Main outcome measures: Frequency of HCRU contacts during the year following latest seizure frequency and mortality (descriptive and Cox proportional hazards regression) from first record of seizure frequency. Results: Higher seizure frequency was related to increased HCRU utilisation and mortality. In negative binomial regression, each category increase in seizure frequency related to 11% more visits to general practitioners, 35% more inpatient admissions, 15% more outpatient visits and increased direct HCRU costs (24%). 11 patients died during 12 490 patient-years follow-up. The unadjusted HR of mortality per higher category of seizure frequency was 2.56 (95% CI: 1.52 to 4.31). Adjustment for age and number of prescribed anti-epileptic drugs at index attenuated this estimate to 2.11 (95% CI: 1.24 to 3.60). Conclusion: Higher seizure frequency is associated with greater HCRU and mortality in CWE in the UK. Improvement in seizure control may potentially lead to better patient outcomes and reduced healthcare use.