Abstract Details

Title Disparities in Epilepsy Surgery for Medically Refractory Epilepsy: Insights from the National Inpatient Sample Database (2016-2019)

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S24 - Epilepsy Clinical Syndromes and Management (5:18 PM-5:30 PM)

Poster/Presentation
Number 010

Background Epilepsy imposes a substantial global health burden. Uncontrolled seizures can lead to physical injuries and an increased risk of sudden unexpected death in epilepsy (SUDEP). Despite the growing recognition of epilepsy surgery as an effective treatment, particularly for drug-resistant cases, the trend of patient population undergoing this procedure remains unexpectedly low

Objective To analyze disparities in the utilization of epilepsy surgery among patients with refractory epilepsy inNational Inpatient Sample database from 2016 to 2019

Design/Methods We extracted data from National Inpatient Sample database from 2016 to 2019, utilizing ICD-10 diagnosis codes and selected patients with admission diagnosis of Intractable Epilepsy and Epileptic surgeries (7.3%) (resective (4%) and implantation/stimulation (3.3%) surgery). Chi-square and T-test were used for descriptive analysis for categorical and continuous variables respectively

Results Among 26,881 patients with intractable epilepsy, the epilepsy surgery rates were similar between pediatric (<18) and adult populations (7.1% vs. 7.4%, p =0.56). White patients were more likely to undergo surgery compared to medical management (68.8% vs. 58.6%; p<0.001), while Black patients were more likely to opt for medical management (9.2% vs.17.4%; p<0.001). Patients with private insurance were more likely to undergo epilepsy surgery (49.9% vs. 33.8%; p<0.001) and self-pay group had higher likelihood of pursuing medical management (2.3% vs. 1.4%; p<0.001). Those in third quartile of median household income ($70,999-$93,999) were more likely to undergo surgery (27.7% vs. 23.8%), while those in the lowest median household income (<$55,999) opted more for medical management (29.7% vs. 21.2%)

Conclusions Our results highlight disparities in the utilization of epilepsy surgery for refractory epilepsy among different patient demographics, specifically with regards to race and insurance status. These findings provide insights into the factors influencing epilepsy surgery decisions and emphasize the need to address utilization gaps

Authors/Disclosures
Prabandh R. Buchhanolla, MBBS PRESENTER	Dr. Buchhanolla has nothing to disclose.
Monika Thapa, MBBS (Department of Neurology)	Dr. Thapa has nothing to disclose.
Abdullahi Musa Adamu, MBBS (Riversacpe apartments)	Dr. Adamu has nothing to disclose.
Lakshmi Chandaluri (LSUHS)	No disclosure on file
Saurabh Kataria, MD (Pier Landing)	Dr. Kataria has nothing to disclose.
Mostafa Hotait, MD	Dr. Hotait has nothing to disclose.
Roohi Katyal, MD (Louisiana State University Health Sciences Center)	Dr. Katyal has nothing to disclose.
Vijayakumar Javalkar, MD, FAAN (LSUHSC Shreveport)	Dr. Javalkar has nothing to disclose.