Śmiertelność w szpitalu i przedłużony pobyt pacjentów z epilepsją i stanem padaczkowym w Ekwadorze
In-hospital mortality and prolonged length of stay of epilepsy and status epilepticus in Ecuador
W skrócie
Badacze przeanalizowali ponad 40 tysięcy przypadków hospitalizacji z powodu epilepsji i stanu padaczkowego w Ekwadorze w latach 2015-2023. Wykazali, że ryzyko śmierci i długotrwałego pobytu w szpitalu znacznie wzrasta wraz z wiekiem, szczególnie u osób po 70. roku życia, oraz że stan padaczkowy wiąże się z wyższą śmiertelnością niż zwykła epilepsja. Wyniki mogą pomóc w opracowaniu lepszych strategii medycznych dla pacjentów z padaczką hospitalizowanych w szpitalach.
Oryginalny abstract (angielski)
INTRODUCTION: Epilepsy and status epilepticus are time-critical neurological conditions linked to in-hospital mortality and prolonged length of stay. This study aimed to evaluate in-hospital mortality and prolonged length of stay associated with epilepsy and status epilepticus in Ecuador during 2015-2023. METHODS: With national hospital discharge data, we assessed hospitalization rates and in-hospital outcomes. Univariable and multivariable logistic regression models estimated crude and adjusted odds ratios (aORs). RESULTS: 40,980 epileptic disorder hospitalization records were assessed, epilepsy accounted 96.66% (n = 39,613), status epilepticus 3.34% (n = 1367). The overall median age was 14 years (IQR: 5-34), with male predominance (53.58%). Children aged 0-9 years comprised the largest share of epilepsy hospitalizations (38.11%). Nevertheless, adjusted odds of admissions being classified as epilepsy were significantly higher among adolescents aged 10-19 years compared to younger children (aOR 1.28, p = 0.002). Conversely, younger children showed higher odds of status epilepticus among hospitalization records compared to adolescents. In-hospital mortality was strongly age-dependent. Ages ≥ 70 years showed markedly higher odds of death (aOR 10.85, p ≤ 0.001). Mortality odds increased in status epilepticus hospitalizations (aOR 9.19, p ≤ 0.001). Prolonged hospital stays (≥6 days) were more frequent in older adults, urban residents, and those admitted to public healthcare facilities. Hospitalization records among individuals aged ≥ 70 years had higher odds of prolonged stays (aOR 1.61, p ≤ 0.001). CONCLUSION: Our results underscore significant age-related differences in hospitalization patterns among hospitalized cases with epileptic disorders. These findings may help inform public health strategies to improve in-hospital outcomes among hospitalized individuals with epilepsy and status epilepticus.