Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Fegan 9, 300 Longwood Avenue, Boston, MA, 02115, USA.
Department of Child Neurology, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.
J Neurol. 2017 Aug;264(8):1735-1745. doi: 10.1007/s00415-017-8560-6. Epub 2017 Jul 12.
The aim is to describe the epidemiology of epilepsy surgery in children and adults in the United States. We performed a descriptive study of the National Inpatient Sample (NIS) for the year 2012 and the Kids' Inpatient Database (KID) for the period 2010-2012, the largest all-payer databases on inpatient data in the USA. These databases estimate 97% of all inpatient hospital discharges in the USA. In the KID, 12,899 (0.2%) of admission records had brain surgery and 600 of the 4900 (12.2%) admissions with focal refractory epilepsy underwent epilepsy surgery. Epilepsy surgery occurred in 60% of Whites, 7% of Blacks, 15% of Hispanics, and 10% of other races. In the NIS, 99,650 (0.3%) of admission records had brain surgery and 1170 of the 9775 (12%) admissions with focal refractory epilepsy underwent epilepsy surgery. Epilepsy surgery occurred in 69% of Whites, 7% of Blacks, 9% of Hispanics, and 8% of other races. In both the KID and the NIS, lower socioeconomic status was mildly underrepresented in epilepsy surgery. In both pediatric and adult admissions, there was an overrepresentation of Whites and underrepresentation of Blacks, which persisted after stratifying by socioeconomic status. Females were underrepresented in epilepsy surgery, but gender disparities were partially explained by differences in socioeconomic status. Epilepsy surgery is not equally distributed across races in the USA and these differences are not fully attributable to differences in socioeconomic status. Racial disparities in epilepsy surgery similarly affect children and adults.
目的在于描述美国儿童和成人癫痫手术的流行病学情况。我们对 2012 年国家住院患者样本（NIS）和 2010-2012 年儿童住院患者数据库（KID）进行了描述性研究，这两个数据库是美国最大的住院患者数据的所有支付方数据库。这些数据库估计美国所有住院患者出院人数的 97%。在 KID 中，12899 份（0.2%）入院记录接受了脑部手术，4900 份（12.2%）局灶性耐药性癫痫入院患者中有 600 人接受了癫痫手术。白人中有 60%接受了癫痫手术，黑人中有 7%，西班牙裔中有 15%，其他种族中有 10%。在 NIS 中，99650 份（0.3%）入院记录接受了脑部手术，9775 份（12%）局灶性耐药性癫痫入院患者中有 1170 人接受了癫痫手术。白人中有 69%接受了癫痫手术，黑人中有 7%，西班牙裔中有 9%，其他种族中有 8%。在 KID 和 NIS 中，社会经济地位较低的患者在癫痫手术中略有代表性不足。在儿科和成人患者中，白人的比例过高，黑人的比例过低，这种情况在按社会经济地位分层后仍然存在。女性在癫痫手术中代表性不足，但性别差异在一定程度上可以通过社会经济地位的差异来解释。在美国，癫痫手术在不同种族之间的分布并不均衡，这些差异不能完全归因于社会经济地位的差异。癫痫手术中的种族差异同样影响儿童和成人。
