Characterization and quantification of epilepsy patients with hospital episodes in Portugal

• Published in: Epilepsy & behavior 2024-06, Vol.155, p.109771, Article 109771
• Main Authors: Bentes, Carla, Canas, Nuno, Pedrosa, Hugo, Completo, João, Pereira, Fábio, Carrilho, Magda, Lopes Lima, José, Pereira, Cristina, Rego, Ricardo, Rocha, Helena, Sá, Francisca, Sales, Francisco, Santos, Manuela, Teotónio, Rute
• Format: Article
• Language: English
• Subjects: Epilepsy; Hospital episodes; Patient quantification; Portugal; Retrospective data
• ISSN: 1525-5050
• DOI: 10.1016/j.yebeh.2024.109771

•In Portugal, the epilepsy burden is uncertain due to a lack of updated evidence.•49,481 epilepsy patients were found in the Portuguese NHS hospitals from 2015 to 2018.•The median age was 64 years with peaks in children and elderly population.•80,494 hospitalizations were recorded, with less than 20% being epilepsy-related.•The death rate in 2018 among these population was 27.59/1,000 epilepsy patients.•Hypertension and psychiatric disorders were the most common comorbidities. Epilepsy affects around 50 million people worldwide and is associated with lower quality of life scores, an increased risk of premature death, and significant socio-economic implications. The lack of updated evidence on current epidemiology and patient characterization creates considerable uncertainty regarding the epilepsy burden in Portugal. The study aims to characterize and quantify the epilepsy patients who have been hospitalized, with medical or surgical procedures involved, and to analyze their associated comorbidities and mortality rates. A multicenter retrospective study was conducted using hospital production data of epilepsy patients. The study included all patients diagnosed with epilepsy-related International Classification of Diseases-9/10 codes between 2015 and 2018 in 57 Portuguese National Health Service (NHS) hospitals (n = 57 institutions). Patient characterization and quantification were done for all patients with an epilepsy diagnosis, with specific analyses focusing on those whose primary diagnosis was epilepsy. Baseline, demographic, and clinical characteristics were analyzed using descriptive statistics. Between 2015 and 2018, a total of 80,494 hospital episodes (i.e., patient visit that generates hospitalization and procedures) were recorded, with 18 % to 19 % directly related to epilepsy. Among these epilepsy-related hospital episodes, 13.0 % led to short term hospitalizations (less than 24 h). Additionally, the average length of stay for all these epilepsy-related episodes was 8 days. A total of 49,481 patients were identified with epilepsy based on ICD-9/10 codes. The median age of patients was 64 years (min: 0; max: 104), with a distribution of 4.8 patients per 1,000 inhabitants. From the total of deaths (9,606) between 2015 and 2018, 14% were associated with patients whose primary diagnosis was epilepsy, with 545 of these being epilepsy-related deaths. Among patients with a primary diagnosis of epilepsy, the most common comorbidities were hypertension (2