Schubert-Bast Susanne, Lenders Clara, Kieslich Matthias, Rosenow Felix, Strzelczyk Adam
Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany; Department of Neuropediatrics, Goethe-University and University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany.
Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany; Department of Neuropediatrics, Goethe-University and University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
Seizure. 2022 Apr;97:63-72. doi: 10.1016/j.seizure.2022.03.014. Epub 2022 Mar 19.
To provide data on inpatient costs and cost-driving factors in children and adolescents due to non-refractory (NSE), refractory (RSE), and super-refractory status epilepticus (SRSE).
All children and adolescents treated for status epilepticus (SE) between 2011 and 2018 at the Frankfurt University Hospital were analyzed for health care utilization.
We evaluated 223 admissions in 174 patients (6.8 ± 5.1 years, median 5.5 years, range 0.1-17.5 years, 109 males [62.6%]) treated for SE. Mean costs of hospital treatment were €5,711 (median €2,330, range = €654-€102,414) per patient per admission, with a mean length of stay (LOS) of 9.2 days (median 5.0, range = 1-101), resulting in mean costs of €621 per SE treatment day. Course of SE had a significant impact on the mean costs, which were €3,386 in NSE (median €2,139, range €654-€38,236, €529 per treatment day; 37% of total inpatient costs due to SE), €7,409 in RSE (median €2,772, range €700-€38,236; €612 per treatment day, 38% of total inpatient costs due to SE) and €17,436 in SRSE (median €6,911, range €2,138-102,414; €842 per treatment day, 25% of total inpatient costs due to SE). Independent cost-driving factors were three or more treatment steps, acute-symptomatic etiology, and unfavorable modified Rankin Scale score at admission. Increased LOS was predicted by three or more treatment steps and unfavorable modified Rankin Scale score at admission. Overall mortality at discharge was 1.3% (three patients).
Acute treatment of SE, and particularly RSE and SRSE, is associated with high hospital costs and prolonged LOS. Patients with disabilities are at risk for an unfavorable course of SE, resulting in prolonged LOS. In general, mortality associated with SE is low in children and adolescents, however three or more treatment steps are associated with high treatment costs.
提供有关儿童和青少年因非难治性（NSE）、难治性（RSE）和超难治性癫痫持续状态（SRSE）导致的住院费用及费用驱动因素的数据。
对2011年至2018年在法兰克福大学医院接受癫痫持续状态（SE）治疗的所有儿童和青少年的医疗资源利用情况进行分析。
我们评估了174例患者的223次住院情况（年龄6.8±5.1岁，中位数5.5岁，范围0.1 - 17.5岁，男性109例[62.6%]），这些患者接受了SE治疗。每次住院每位患者的平均住院费用为5711欧元（中位数2330欧元，范围654 - 102414欧元），平均住院时长（LOS）为9.2天（中位数5.0天，范围1 - 101天），导致SE治疗日均费用为621欧元。SE的病程对平均费用有显著影响，NSE的平均费用为3386欧元（中位数2139欧元，范围654 - 38236欧元，每日治疗费用529欧元；占SE导致的总住院费用的37%），RSE为7409欧元（中位数2772欧元，范围700 - 38236欧元；每日治疗费用612欧元，占SE导致的总住院费用的38%），SRSE为17436欧元（中位数6911欧元，范围2138 - 102414欧元；每日治疗费用842欧元，占SE导致的总住院费用的25%）。独立的费用驱动因素为三个或更多治疗步骤、急性症状性病因以及入院时改良Rankin量表评分不佳。三个或更多治疗步骤以及入院时改良Rankin量表评分不佳可预测住院时长增加。出院时的总体死亡率为1.3%（3例患者）。
SE的急性治疗，尤其是RSE和SRSE，与高昂的住院费用和延长的住院时长相关。残疾患者发生SE不良病程的风险较高，导致住院时长延长。总体而言，儿童和青少年中与SE相关的死亡率较低，然而三个或更多治疗步骤与高昂的治疗费用相关。
