Factors involved in time reduction between seizure relapses in patients with epilepsy attending emergency rooms in Medellín, Colombia

Autor: Rafael Bernal Cobo, Lilliana María Giraldo Tapias, Tatiana Gómez Escobar, Luisa Fernanda Rueda Cárdenas, José Fernando Zapata Berruecos, Elsa María Vásquez Trespalacios, Yessica María Giraldo Castrillón, Diego Fernando Rojas-Gualdrón
Rok vydání: 2022
Předmět:
Zdroj: Epilepsy & Behavior. 126:108458
ISSN: 1525-5050
DOI: 10.1016/j.yebeh.2021.108458
Popis: Seizure relapses are the leading cause of admission to emergency rooms (ER) in people with epilepsy.To analyze administrative and clinical factors associated with the duration between seizure relapses in people with epilepsy admitted to the Neurological Institute of Colombia (Medellin) between July 2018 and July 2019.A retrospective follow-up study of 156 patients over 18 years old, diagnosed with epilepsy, and treated for over a year. The outcome variable was the time between seizure relapses, identified through the record of ER attendances. In addition, difficulties in the prescription filling process (delay, omission, or brand change) and clinical characteristics were analyzed as potential associated influence factors. The statistical analysis was performed using the Prentice, WilliamsPeterson-Gap Time survival model for recurrent events. Finally, Adjusted Hazard Ratios (aHR) with 95% confidence intervals (95%CI) are also presented.One hundred fifty-six patients were analyzed. Their average age of diagnosis was 15.5 years (SD = 22.5), the median number of monthly seizures was 3 (SD = 9.3), and 50.6% were women. Moreover, difficulties in the prescription filling process were associated with a time reduction between seizure relapses (aHR = 2.61; 95%CI 1.49-4.57), showing a similar impact as having a history of three or four types of events (aHR = 2.96; 95%CI 1.23-7.12) and neuropsychiatric comorbidity (aHR = 1.89; 95%CI 1.04-3.54).Neuropsychiatric comorbidity, history of several types of events, and experiencing difficulties with prescription filling are associated with lower benefit from treatment to control seizure relapses.
Databáze: OpenAIRE