Hospitalization Cost in Patients with Non-convulsive Status Epilepticus: Is it Different from Other Critical Care Patients?

Abstract

Objective: Status epilepticus (SE) is one of the severe neurological emergencies with significant morbidity and mortality. Most of the time these patients require admission to intensive care units. There is little information about health-economy related burden of SE and potential factors affecting cost except for developed Western countries, especially from the perspective of non-convulsive SE (NCSE).

Materials and Methods: We included all consecutive patients diagnosed as having NCSE with continuous electroencephalogram (EEG) in our neurological intensive care unit (NICU) between 2009 and 2019. Demographic and clinical features were collected from patient files. Total cost during NICU care was obtained from hospital financial records. The results were compared with other NICU patients (control group) followed during the same period for the same length of stay. We also investigated the potential impact of several parameters on cost.

Results: Thirty two patients with NCSE and 32 controls were included. Mean cost per patient was 11,831 US dollars (USD) in the study and 11,240 USD in the control group (p=0.386). Increased length of stay (p<0.001), lower Glasgow Coma scale score at admission (p=0.003), and new diagnosis of NCSE after admission to NICU (p=0.018) were significantly associated with higher cost in study group. SE related direct costs (anti-seizure medicines, anesthetics and continuous EEG) comprised only 3% of total NICU care expenditures.

Conclusion: Management for NCSE in NICU leads to significant intensive care related cost. The similarity of the cost level to other NICU patients indicates that most of the expenditures are related to intensive care, rather than management of seizures. We found that a few patient-related parameters could significantly affect the cost, but they were all non-modifiable.

The study was approved by the Hacettepe University Faculty of Medicine Local Institutional Ethics Committee (approval no: FON 08/19-53, date: 01.05.2008).

Written informed consent was obtained prior to EEG recording in the study cohort.

Externally and internally peer-reviewed.

Concept: C.A.Ç., O.S., N.D., Design: E.M.A., M.A.T., N.D., Data Collection or Processing: C.A.Ç., O.S., Analysis or Interpretation: C.A.Ç., E.M.A., M.A.T., N.D., Literature Search: C.A.Ç., E.M.A., M.A.T., N.D., Writing: N.D.

No conflict of interest was declared by the authors.

This study was supported by Hacettepe University Research Fund, grant no: 1-801 105 001 (ND) .