Psychiatric Comorbidities and Inpatient Outcomes in Epilepsy Patients During Hospitalization: An Analysis of the United States Nationwide Inpatient Sample

December 21, 2017

This poster was presented at the 30th annual  Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.

BACKGROUND: Psychiatric comorbidities in epilepsy impose significant burdens on the patients. This is the first study, to our knowledge, to report the impact of various psychiatric comorbidities in epilepsy patients regarding hospital outcomes.

METHODS: We used the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from year's 2013-2014. We identified Epilepsy as a primary diagnosis and psychiatric comorbidities namely; alcohol abuse, depression, drug abuse and psychosis using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD_9-_CM) codes. Differences in comorbidities were quantified using Chi-Square (_2) tests and multinomial logistic regression model was used to quantify associations among comorbidities and inpatient mortality, length of stay and inpatient charge (aOR).

RESULTS: We analysed 397,440 hospitalizations with Epilepsy as primary diagnosis. The most prevalent psychiatric comorbidities present in Epilepsy were depression (13%) followed by psychosis (10.4%). The risk of inpatient death was only seen in Epilepsy with comorbid alcohol abuse (aOR 1.164; p-value= 0.007). Epilepsy with comorbid depression (aOR 1.473; p-value<0.001) was associated with a higher risk of length of stay of more than 3 days, followed by comorbid psychosis (aOR 1.290; p-value<0.001). Epilepsy with the comorbid depression (aOR 1.242; p-value<0.001) was associated with a higher risk of inpatient total charge of more than $21,000, followed by comorbid psychosis (aOR 1.071; p-value<0.001).

CONCLUSION: Psychiatric comorbidities are influential factors that must be considered in models of health-related quality of life (HRQOL) in Epilepsy. Further, efforts to improve HRQOL and lessen the burden of Epilepsy requires greater emphasis on early diagnosis and treatment of comorbid psychopathology.

Rikinkumar Patel, MD, MPH; Mandeep Kaur, MD; Ahmed Elmaadawi, MD; Zeeshan Mansuri, MD, MPH; Kaushal Shah, MBBS, MPH; Suhayl Nasr, MD