Department of Neurology, Emory University School of Medicine, Atlanta, Georgia.
Department of Health Policy, Emory University School of Medicine, Atlanta, Georgia.
Epilepsy Res. 2023 Feb;190:107084. doi: 10.1016/j.eplepsyres.2023.107084. Epub 2023 Jan 14.
Epilepsy can reduce quality of life (QOL), functionality, and social participation, but these effects have not been adequately quantified in large, population-based, controlled studies. We sought to evaluate the impact of epilepsy on patients' QOL and employment outcomes.
In this cross-sectional study we used nationally representative, pooled data from the Medical Expenditure Panel Survey (MEPS) household component files for 2010-2018. MEPS is a population-based survey of U.S. community-dwelling persons. We included respondents with condition file records for epilepsy. We also analyzed respondents with records for seizure. The primary outcomes were short form-12 physical and mental health scores. Secondary outcomes included self-rated health status, employment status, educational attainment, school/household/work limitations, and missed workdays. We compared these outcomes between persons with epilepsy (PWE) and age- and gender-matched controls.
We identified 1078 people with epilepsy, 2344 seizure cases, and 3422 cases of either condition (persons with epilepsy and/or seizures). Epilepsy was associated with a decrease of - 4.0 (95% CI: -5.1 to -2.8) points in SF-12 physical health scores and - 3.1 (95% CI: -4.2 to -1.9) in SF-12 mental health scores. Epilepsy was also associated with decreases in the likelihood of reporting good/very good/excellent health status (-13.3 [95% CI: -16.1 to -10.4] percentage points). Epilepsy was also associated with adverse employment-related outcomes. Specifically, PWE were 17.9 (95% CI: 14.3-21.4) percentage points more likely to report that they had work or household limitations. The associations between outcomes and epilepsy were, in most cases, larger than those between outcomes and other common, chronic conditions.
Epilepsy is associated with worse quality of life and employment-related outcomes. Interventions should aim to improve functioning and patients' ability to maintain employment.
癫痫可降低生活质量（QOL）、功能和社会参与度，但这些影响在大型、基于人群、对照研究中尚未得到充分量化。我们旨在评估癫痫对患者 QOL 和就业结果的影响。
在这项横断面研究中，我们使用了 2010 年至 2018 年全国代表性、汇总的医疗支出面板调查（MEPS）家庭组成文件中的数据。MEPS 是对美国社区居住者的人口普查。我们纳入了有条件档案记录的癫痫患者。我们还分析了有癫痫发作记录的受访者。主要结果是简短形式 12 项身体和心理健康评分。次要结果包括自我报告的健康状况、就业状况、教育程度、学校/家庭/工作限制以及错过工作日数。我们比较了癫痫患者（PWE）和年龄及性别匹配对照组之间的这些结果。
我们发现了 1078 名癫痫患者、2344 例癫痫发作病例以及 3422 例任意一种疾病（癫痫患者和/或癫痫发作）的病例。癫痫导致 SF-12 身体健康评分降低了 -4.0（95%CI：-5.1 至 -2.8）分，SF-12 心理健康评分降低了 -3.1（95%CI：-4.2 至 -1.9）分。癫痫还与报告良好/非常好/优秀健康状况的可能性降低有关（-13.3% [95%CI：-16.1%至-10.4%]）。癫痫还与不良的与就业相关的结果有关。具体来说，PWE 报告工作或家庭限制的可能性高 17.9%（95%CI：14.3%至 21.4%）。在大多数情况下，与癫痫相关的结果与其他常见的慢性疾病相比，与结果的相关性更大。
癫痫与较差的生活质量和与就业相关的结果有关。干预措施应旨在改善功能和患者维持就业的能力。
