Dataset Information

Status Epilepticus among Older Adults in the United States.

ABSTRACT:

Objective

This study aimed to identify temporal time trends and risk factors associated with mortality for hospitalized older adults with status epilepticus (SE).

Design

A retrospective study was performed.

Setting

Hospitalized patients were identified utilizing an administrative database-The Nationwide Inpatient Sample database from 1998 through September 2015.

Patients

Patients were older adults 65 years and older with SE.

Interventions

No interventions were undertaken.

Measurements and main results

Demographic, temporal trends, clinical characteristics, and outcome data were abstracted. The results indicated that hospitalized elderly Americans with SE increased over the 11-year study period. Univariate and multivariate analyses were performed to evaluate risk factors associated with mortality in the study cohort. From the weighted sample, 130,109 subjects were included. Overall mortality was 19%. For age subgroups, the mortality was highest for the >85 years age group (24.1%) compared to the 65-75 years (19%) and 75-85 years (23%) age groups. Among investigated etiologies, the three most common causes of SE were acute ischemic stroke (11.2% of total) followed by non-traumatic brain hemorrhage (5.4%) and malignant brain lesions (4.9%). The highest mortality by etiology was noted for acute traumatic brain injury (TBI) (31.5%), non-traumatic brain hemorrhage (31%), and acute ischemic stroke (AIS) (30.1%). Multivariate analysis indicated that non-survivors when compared to survivors were more like to have the following characteristics: older age group, acute TBI, brain neoplasms, non-traumatic brain hemorrhage, AIS and central nervous system (CNS) infections, and utilization of mechanical ventilation. Associated conditions significantly increasing risk of mortality were sodium imbalance, cardiac arrest, anoxic brain injury, pneumonia, and sepsis. Comorbidities associated with increased risk of mortality included valvular heart disease, renal failure, liver disease, and neoplasms.

Conclusions

The number of hospitalized elderly Americans with SE increased over the 11-year study period. Overall mortality was 19%, with even higher mortality among various patient subsets. Several demographic and co-morbid factors are associated with increased mortality in this age group.

SUBMITTER: Mendiratta P

PROVIDER: S-EPMC6787625 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Status Epilepticus among Older Adults in the United States.

Mendiratta Priya P Dayama Neeraj N Wei Jeanne Y JY Prodhan Pallavi P Prodhan Parthak P

Geriatrics (Basel, Switzerland) 20190723 3

<h4>Objective</h4>This study aimed to identify temporal time trends and risk factors associated with mortality for hospitalized older adults with status epilepticus (SE).<h4>Design</h4>A retrospective study was performed.<h4>Setting</h4>Hospitalized patients were identified utilizing an administrative database-The Nationwide Inpatient Sample database from 1998 through September 2015.<h4>Patients</h4>Patients were older adults 65 years and older with SE.<h4>Interventions</h4>No interventions were ...[more]

PMID: 31340576

Similar Datasets

Project description:OBJECTIVES:To determine the prevalence and impact of common co-occurring symptoms among community-dwelling older adults in the United States. DESIGN:The National Health and Aging Trends Study is a nationally representative, prospective study with annual data collection between 2011 and 2017. SETTING:Community-based, in-person interviews (survey response rates, 71%-96%). PARTICIPANTS:A total of 7,609 community-dwelling Medicare beneficiaries, 65 years or older. MEASUREMENTS:Symptoms assessed at baseline include pain, fatigue, breathing difficulty, sleeping difficulty, depressed mood, and anxiety. Total symptom count ranged from zero to six. Several outcomes were examined, including grip strength, gait speed, and overall lower-extremity function as well as incidence of recurrent falls (two or more per year), hospitalization, disability, nursing home admission, and mortality. RESULTS:Prevalence of zero, one, two, three, and four or more symptoms was 25.0%, 26.6%, 20.7%, 14.0%, and 13.6%, respectively. Symptom count increased with advancing age and was higher in women than in men. Pain and fatigue were the most common co-occurring symptoms. Higher symptom count was associated with decreased physical capacity. For example, participants with one, two, three, and four or more symptoms had gait speeds that were 0.04, 0.06, 0.09, and 0.13 m/s slower, respectively, than those with no symptoms, adjusting for specific diseases, total number of diseases, and other potential confounders (P < .001). The risk of several adverse outcomes also increased with greater symptom count. For example, compared with those with no symptoms, the adjusted risk ratios for recurrent falls were 1.48 (95% confidence interval [CI] = 1.30-1.70), 1.54 (95% CI = 1.32-1.80), 1.90 (95% CI = 1.55-2.32), and 2.38 (95% CI = 2.00-2.83) for older adults with one, two, three, and four or more symptoms, respectively. CONCLUSIONS:Symptoms frequently co-occur among community-dwelling older adults and are strongly associated with increased risk of a range of adverse outcomes. Symptoms represent a potential treatment target for improving outcomes and should be systematically captured in health records. J Am Geriatr Soc 67:223-231, 2019.

Dataset Information

Status Epilepticus among Older Adults in the United States.

Objective

Design

Setting

Patients

Interventions

Measurements and main results

Conclusions

Publications

Status Epilepticus among Older Adults in the United States.

Similar Datasets

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