Cost of status epilepticus (SE): Effects of delayed treatment and SE duration

Estevo Santamarina, Beatriz Parejo, Laura Abraira, Álvaro Gutiérrez-Viedma, Alicia Alpuente, Belén Abarrategui, Manuel Toledo, Gonzalo Mazuela, Xavier Salas-Puig, Manuel Quintana, Irene García-Morales

    Research output: Contribution to journalArticleResearch

    6 Citations (Scopus)

    Abstract

    © 2018 Elsevier Inc. Background: The health expenditure related to status epilepticus (SE) is high because of lengthy hospitalization requirements and possible sequelae. We aimed to study the factors associated with this cost including the different timings of the treatment and SE duration. Methods: We evaluated retrospectively all SE recorded in 2 hospitals. The factors studied included the mean cost of hospitalization, demographics, clinical data, duration of hospitalization, in-hospital/out-of-hospital debut, time from onset to treatment, duration of SE, and destination at discharge. Results: Three hundred five patients were evaluated (December/2012–July/2017), 195 with out-of hospital and 110 with in-hospital debut. The cost of SE with out-of-hospital onset was significantly lower (6559€ vs 15,174€; p = 0.0001). In out-of-hospital cases, the factors independently related to expenditure were the level of consciousness (p < 0.001), presence of complications (p = 0.005), a potentially fatal etiology (p = 0.008), and duration of the episode (p = 0.003). Duration was significantly higher in patients discharged to a convalescence center (p = 0.006); this variable was significantly related to the time SE onset–arrival to hospital, and SE onset–administration of the treatment. In the in-hospital cases, cost was related to male sex (p = 0.002), the development of complications (p = 0.003), and the etiology (p = 0.016) but was not directly related to the SE duration or to the time onset-treatment. Conclusions: The duration of SE and the speed with which proper management is applied have a direct impact on the healthcare expenditure resulting from out-of-hospital SE. In contrast, the etiology and development of complications are the main factors responsible for expenditure related to in-hospital SE.
    Original languageEnglish
    Pages (from-to)8-14
    JournalEpilepsy and Behavior
    Volume89
    DOIs
    Publication statusPublished - 1 Dec 2018

    Keywords

    • Cost-of-illness
    • Duration
    • Status epilepticus

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