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Costs and cost‐driving factors for acute treatment of adults with status epilepticus: A multicenter cohort study from Germany
Author(s) -
Kortland LenaMarie,
Alfter Anne,
Bähr Oliver,
Carl Barbara,
Dodel Richard,
Freiman Thomas M.,
Hubert Kristina,
Jahnke Kolja,
Knake Susanne,
Podewils Felix,
Reese JensPeter,
Runge Uwe,
Senft Christian,
Steinmetz Helmuth,
Rosenow Felix,
Strzelczyk Adam
Publication year - 2016
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13584
Subject(s) - status epilepticus , medicine , refractory (planetary science) , mechanical ventilation , cohort , pediatrics , epilepsy , anesthesia , emergency medicine , psychiatry , physics , astrobiology
Summary Objective To provide first data on inpatient costs and cost‐driving factors due to nonrefractory status epilepticus ( NSE ), refractory status epilepticus ( RSE ), and super‐refractory status epilepticus ( SRSE ). Methods In 2013 and 2014, all adult patients treated due to status epilepticus ( SE ) at the university hospitals in Frankfurt, Greifswald, and Marburg were analyzed for healthcare utilization. Results We evaluated 341 admissions in 316 patients (65.7 ± [standard deviation]18.2 years; 135 male) treated for SE . Mean costs of hospital treatment were €14,946 (median €5,278, range €776–€152,911, €787 per treatment day) per patient per admission, with a mean length of stay ( LOS ) of 19.0 days (median 14.0, range 1–118). Course of SE had a significant impact on mean costs, with €8,314 in NSE (n = 137, median €4,597, €687 per treatment day, 22.3% of total inpatient costs due to SE ), €13,399 in RSE (n = 171, median €7,203, €638/day, 45.0% of total costs, p < 0.001), and €50,488 in SRSE (n = 33, median €46,223, €1,365/day, 32.7% of total costs, p < 0.001). Independent cost‐driving factors were SRSE , ventilation, and LOS of >14 days. Overall mortality at discharge was 14.4% and significantly higher in RSE / SRSE (20.1%) than in NSE (5.8%). Significance Acute treatment of SE , and particularly SRSE and ventilation, are associated with high hospital costs and prolonged LOS . Extrapolation to the whole of Germany indicates that SE causes hospital costs of >€200 million per year. Along with the demographic change, incidence of SE will increase and costs for hospital treatment and sequelae of SE will rise.