Psychiatric Comorbidities and Outcomes in Epilepsy Patients: An Insight from a Nationwide Inpatient Analysis in the United States
Background Psychiatric comorbidities in epilepsy impose significant burdens on patients and their families. It affects their quality of life and medical care and results in cost increases. This study reports the impact of various psychiatric comorbidities in epilepsy patients regarding hospital outc...
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| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2017-09, Vol.9 (9), p.e1686-e1686 |
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| description | Background Psychiatric comorbidities in epilepsy impose significant burdens on patients and their families. It affects their quality of life and medical care and results in cost increases. This study reports the impact of various psychiatric comorbidities in epilepsy patients regarding hospital outcomes and in-hospital mortality. Methods We used the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2013-2014. We identified epilepsy as the primary diagnosis and psychiatric comorbidities, namely, alcohol abuse, depression, drug abuse, and psychosis, using validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD--9--CM) codes. The differences in comorbidities were quantified using chi-square (χ
) tests and the multinomial logistic regression model was used to quantify associations among comorbidities using the adjusted Odds Ratio (aOR). Results We analyzed 397,440 hospitalizations with epilepsy as the 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; 95%CI 1.043 - 1.300; p-value =0.007). Epilepsy with comorbid depression (aOR 1.473; 95% CI 1.391 - 1.559; p-value |
| doi_str_mv | 10.7759/cureus.1686 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5685646</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1966447497</sourcerecordid><originalsourceid>FETCH-LOGICAL-c339t-51f02d52e1e4bef900dd73e751b2268c34b98c023df974318be182434916282d3</originalsourceid><addsrcrecordid>eNpdkc1rFTEUxYMottSu3EvAjSCv5mvy4UIoj1YLxRa065BJMn0pM8mYZJS39D9vnq-W6ubeG86PwyEHgNcYnQjRqQ92yX4pJ5hL_gwckrZXEkv2_Ml9AI5LuUMIYSQIEuglOCAKd4Qxegh-X5et3QRTc7BwnaaU--BCDb5AEx28WqpNU3uECM_mMPq5bOG1aXqs5SM8jfAilnC7qXDIaYIGfm1air-C802Z92DDzLgt4Y9L3Xh4E0P1Dn6rpvryCrwYzFj88cM-AjfnZ9_XX1aXV58v1qeXK0upqqsOD4i4jnjsWe8HhZBzgnrR4Z4QLi1lvZIWEeoGJRjFsvdYEkaZwpxI4ugR-LT3nZd-8s62YNmMes5hMnmrkwn6XyWGjb5NP3XHZccZbwbvHgxy-rH4UvUUivXjaKJPS9FYcc6YYEo09O1_6F1acvuFHSVQh0kbjXq_p2xOpWQ_PIbBSO_a1ft29a7dRr95mv-R_dslvQdUYaKJ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1970512705</pqid></control><display><type>article</type><title>Psychiatric Comorbidities and Outcomes in Epilepsy Patients: An Insight from a Nationwide Inpatient Analysis in the United States</title><source>PubMed Central Open Access</source><source>PubMed Central</source><creator>Patel, Rikinkumar S ; Elmaadawi, Ahmed ; Mansuri, Zeeshan ; Kaur, Mandeep ; Shah, Kaushal ; Nasr, Suhayl</creator><creatorcontrib>Patel, Rikinkumar S ; Elmaadawi, Ahmed ; Mansuri, Zeeshan ; Kaur, Mandeep ; Shah, Kaushal ; Nasr, Suhayl</creatorcontrib><description>Background Psychiatric comorbidities in epilepsy impose significant burdens on patients and their families. It affects their quality of life and medical care and results in cost increases. This study reports the impact of various psychiatric comorbidities in epilepsy patients regarding hospital outcomes and in-hospital mortality. Methods We used the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2013-2014. We identified epilepsy as the primary diagnosis and psychiatric comorbidities, namely, alcohol abuse, depression, drug abuse, and psychosis, using validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD--9--CM) codes. The differences in comorbidities were quantified using chi-square (χ
) tests and the multinomial logistic regression model was used to quantify associations among comorbidities using the adjusted Odds Ratio (aOR). Results We analyzed 397,440 hospitalizations with epilepsy as the 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; 95%CI 1.043 - 1.300; p-value =0.007). Epilepsy with comorbid depression (aOR 1.473; 95% CI 1.391 - 1.559; p-value <0.001) was associated with a higher risk of a length of stay of more than three days (median), followed by comorbid psychosis (aOR 1.290; 95% CI 1.258 - 1.322; p-value <0.001). Epilepsy with comorbid depression (aOR 1.242; 95% CI 1.172 - 1.317; p-value <0.001) was associated with a higher risk of inpatient total charge of more than $21,000 (median), followed by comorbid psychosis (aOR 1.071; 95% CI 1.045 - 1.098; 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 reduce the burden of epilepsy require greater emphasis on the early diagnosis and treatment of comorbid psychopathology.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.1686</identifier><identifier>PMID: 29152443</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Age ; Alcohol ; Alcohol abuse ; Behavior disorders ; Classification ; Codes ; Comorbidity ; Epilepsy ; Health care expenditures ; Health maintenance organizations ; HMOs ; Hospitals ; Medicaid ; Mental depression ; Mortality ; Neurology ; Patients ; Population ; Psychiatry ; Psychopathology ; Psychosis ; Quality Improvement ; Quality of life ; Software ; Statistical analysis ; Substance abuse treatment ; Variables</subject><ispartof>Curēus (Palo Alto, CA), 2017-09, Vol.9 (9), p.e1686-e1686</ispartof><rights>Copyright © 2017, Patel et al. This work is licensed under the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/3.0/ ) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2017, Patel et al. 2017 Patel et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c339t-51f02d52e1e4bef900dd73e751b2268c34b98c023df974318be182434916282d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685646/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685646/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29152443$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patel, Rikinkumar S</creatorcontrib><creatorcontrib>Elmaadawi, Ahmed</creatorcontrib><creatorcontrib>Mansuri, Zeeshan</creatorcontrib><creatorcontrib>Kaur, Mandeep</creatorcontrib><creatorcontrib>Shah, Kaushal</creatorcontrib><creatorcontrib>Nasr, Suhayl</creatorcontrib><title>Psychiatric Comorbidities and Outcomes in Epilepsy Patients: An Insight from a Nationwide Inpatient Analysis in the United States</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Background Psychiatric comorbidities in epilepsy impose significant burdens on patients and their families. It affects their quality of life and medical care and results in cost increases. This study reports the impact of various psychiatric comorbidities in epilepsy patients regarding hospital outcomes and in-hospital mortality. Methods We used the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2013-2014. We identified epilepsy as the primary diagnosis and psychiatric comorbidities, namely, alcohol abuse, depression, drug abuse, and psychosis, using validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD--9--CM) codes. The differences in comorbidities were quantified using chi-square (χ
) tests and the multinomial logistic regression model was used to quantify associations among comorbidities using the adjusted Odds Ratio (aOR). Results We analyzed 397,440 hospitalizations with epilepsy as the 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; 95%CI 1.043 - 1.300; p-value =0.007). Epilepsy with comorbid depression (aOR 1.473; 95% CI 1.391 - 1.559; p-value <0.001) was associated with a higher risk of a length of stay of more than three days (median), followed by comorbid psychosis (aOR 1.290; 95% CI 1.258 - 1.322; p-value <0.001). Epilepsy with comorbid depression (aOR 1.242; 95% CI 1.172 - 1.317; p-value <0.001) was associated with a higher risk of inpatient total charge of more than $21,000 (median), followed by comorbid psychosis (aOR 1.071; 95% CI 1.045 - 1.098; 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 reduce the burden of epilepsy require greater emphasis on the early diagnosis and treatment of comorbid psychopathology.</description><subject>Age</subject><subject>Alcohol</subject><subject>Alcohol abuse</subject><subject>Behavior disorders</subject><subject>Classification</subject><subject>Codes</subject><subject>Comorbidity</subject><subject>Epilepsy</subject><subject>Health care expenditures</subject><subject>Health maintenance organizations</subject><subject>HMOs</subject><subject>Hospitals</subject><subject>Medicaid</subject><subject>Mental depression</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Patients</subject><subject>Population</subject><subject>Psychiatry</subject><subject>Psychopathology</subject><subject>Psychosis</subject><subject>Quality Improvement</subject><subject>Quality of life</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Substance abuse treatment</subject><subject>Variables</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkc1rFTEUxYMottSu3EvAjSCv5mvy4UIoj1YLxRa065BJMn0pM8mYZJS39D9vnq-W6ubeG86PwyEHgNcYnQjRqQ92yX4pJ5hL_gwckrZXEkv2_Ml9AI5LuUMIYSQIEuglOCAKd4Qxegh-X5et3QRTc7BwnaaU--BCDb5AEx28WqpNU3uECM_mMPq5bOG1aXqs5SM8jfAilnC7qXDIaYIGfm1air-C802Z92DDzLgt4Y9L3Xh4E0P1Dn6rpvryCrwYzFj88cM-AjfnZ9_XX1aXV58v1qeXK0upqqsOD4i4jnjsWe8HhZBzgnrR4Z4QLi1lvZIWEeoGJRjFsvdYEkaZwpxI4ugR-LT3nZd-8s62YNmMes5hMnmrkwn6XyWGjb5NP3XHZccZbwbvHgxy-rH4UvUUivXjaKJPS9FYcc6YYEo09O1_6F1acvuFHSVQh0kbjXq_p2xOpWQ_PIbBSO_a1ft29a7dRr95mv-R_dslvQdUYaKJ</recordid><startdate>20170914</startdate><enddate>20170914</enddate><creator>Patel, Rikinkumar S</creator><creator>Elmaadawi, Ahmed</creator><creator>Mansuri, Zeeshan</creator><creator>Kaur, Mandeep</creator><creator>Shah, Kaushal</creator><creator>Nasr, Suhayl</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170914</creationdate><title>Psychiatric Comorbidities and Outcomes in Epilepsy Patients: An Insight from a Nationwide Inpatient Analysis in the United States</title><author>Patel, Rikinkumar S ; Elmaadawi, Ahmed ; Mansuri, Zeeshan ; Kaur, Mandeep ; Shah, Kaushal ; Nasr, Suhayl</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c339t-51f02d52e1e4bef900dd73e751b2268c34b98c023df974318be182434916282d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Alcohol</topic><topic>Alcohol abuse</topic><topic>Behavior disorders</topic><topic>Classification</topic><topic>Codes</topic><topic>Comorbidity</topic><topic>Epilepsy</topic><topic>Health care expenditures</topic><topic>Health maintenance organizations</topic><topic>HMOs</topic><topic>Hospitals</topic><topic>Medicaid</topic><topic>Mental depression</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Patients</topic><topic>Population</topic><topic>Psychiatry</topic><topic>Psychopathology</topic><topic>Psychosis</topic><topic>Quality Improvement</topic><topic>Quality of life</topic><topic>Software</topic><topic>Statistical analysis</topic><topic>Substance abuse treatment</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Rikinkumar S</creatorcontrib><creatorcontrib>Elmaadawi, Ahmed</creatorcontrib><creatorcontrib>Mansuri, Zeeshan</creatorcontrib><creatorcontrib>Kaur, Mandeep</creatorcontrib><creatorcontrib>Shah, Kaushal</creatorcontrib><creatorcontrib>Nasr, Suhayl</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Rikinkumar S</au><au>Elmaadawi, Ahmed</au><au>Mansuri, Zeeshan</au><au>Kaur, Mandeep</au><au>Shah, Kaushal</au><au>Nasr, Suhayl</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychiatric Comorbidities and Outcomes in Epilepsy Patients: An Insight from a Nationwide Inpatient Analysis in the United States</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2017-09-14</date><risdate>2017</risdate><volume>9</volume><issue>9</issue><spage>e1686</spage><epage>e1686</epage><pages>e1686-e1686</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Background Psychiatric comorbidities in epilepsy impose significant burdens on patients and their families. It affects their quality of life and medical care and results in cost increases. This study reports the impact of various psychiatric comorbidities in epilepsy patients regarding hospital outcomes and in-hospital mortality. Methods We used the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2013-2014. We identified epilepsy as the primary diagnosis and psychiatric comorbidities, namely, alcohol abuse, depression, drug abuse, and psychosis, using validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD--9--CM) codes. The differences in comorbidities were quantified using chi-square (χ
) tests and the multinomial logistic regression model was used to quantify associations among comorbidities using the adjusted Odds Ratio (aOR). Results We analyzed 397,440 hospitalizations with epilepsy as the 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; 95%CI 1.043 - 1.300; p-value =0.007). Epilepsy with comorbid depression (aOR 1.473; 95% CI 1.391 - 1.559; p-value <0.001) was associated with a higher risk of a length of stay of more than three days (median), followed by comorbid psychosis (aOR 1.290; 95% CI 1.258 - 1.322; p-value <0.001). Epilepsy with comorbid depression (aOR 1.242; 95% CI 1.172 - 1.317; p-value <0.001) was associated with a higher risk of inpatient total charge of more than $21,000 (median), followed by comorbid psychosis (aOR 1.071; 95% CI 1.045 - 1.098; 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 reduce the burden of epilepsy require greater emphasis on the early diagnosis and treatment of comorbid psychopathology.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>29152443</pmid><doi>10.7759/cureus.1686</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Age Alcohol Alcohol abuse Behavior disorders Classification Codes Comorbidity Epilepsy Health care expenditures Health maintenance organizations HMOs Hospitals Medicaid Mental depression Mortality Neurology Patients Population Psychiatry Psychopathology Psychosis Quality Improvement Quality of life Software Statistical analysis Substance abuse treatment Variables |
| title | Psychiatric Comorbidities and Outcomes in Epilepsy Patients: An Insight from a Nationwide Inpatient Analysis in the United States |
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