Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.
CINTESIS@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.
Epilepsy Behav. 2023 Nov;148:109447. doi: 10.1016/j.yebeh.2023.109447. Epub 2023 Oct 5.
Psychiatric comorbidities are highly frequent in people with epilepsy and were found to be markers of poorer prognosis. These comorbidities increase the use of healthcare resources, including emergency department visits and inpatient care. Despite this, there is little information on healthcare utilization associated with a wide range of comorbid mental disorders in people with epilepsy (PWE).
To characterize registered mental disorders among all hospitalizations with a primary diagnosis of epilepsy and to analyze their association with crucial hospitalization outcomes.
An observational retrospective study was performed using administrative data from hospitalization episodes with epilepsy as the primary diagnosis discharged between 2008 and 2015. Mental disorder categories 650 to 670 from Clinical Classification Software were selected as secondary diagnoses. Mann-Whitney U, Kruskall-Wallis, and Chi-squared tests were used to establish comparisons. For each episode, data regarding hospitalization outcomes was retrieved, including length of stay (LoS), in-hospital mortality (IHM), 8-year period readmissions, and total estimated charges.
Overall, 27,785 hospitalizations were analyzed and 33.9% had registered mental disorders, with alcohol-related disorders being the most prevalent (11.7%). For episodes with a concomitant register of a mental disorder, LoS was significantly longer (5.0 vs. 4.0 days, P <0.001), and IHM was higher (2.8% vs. 2.2%, P <0.001), as were readmissions (25.5% vs. 23.7%, P <0.001), and median episodes' charges (1,578.7 vs. 1,324.4 euros, P <0.001).
Epilepsy-related hospitalizations with registered mental disorders heightened the utilization of healthcare resources, stressing the importance of diagnosing and treating mental disorders in PWE.
精神共病在癫痫患者中非常常见，并且被认为是预后较差的标志物。这些合并症会增加医疗保健资源的使用，包括急诊就诊和住院治疗。尽管如此，对于癫痫患者（PWE）广泛的合并精神障碍相关的医疗保健利用情况，信息仍然很少。
描述所有以癫痫为主要诊断的住院患者中已登记的精神障碍，并分析其与关键住院结局的关系。
使用 2008 年至 2015 年期间以癫痫为主要诊断的出院住院患者的行政数据进行观察性回顾性研究。选择临床分类软件中的精神障碍类别 650 至 670 作为次要诊断。使用 Mann-Whitney U、Kruskal-Wallis 和卡方检验进行比较。对于每个住院患者，检索有关住院结局的数据，包括住院时间（LoS）、院内死亡率（IHM）、8 年期间再入院率和总估计费用。
共分析了 27785 例住院患者，其中 33.9%有已登记的精神障碍，其中酒精相关障碍最为常见（11.7%）。对于伴有精神障碍登记的住院患者，LoS 明显更长（5.0 天 vs. 4.0 天，P <0.001），IHM 更高（2.8% vs. 2.2%，P <0.001），再入院率更高（25.5% vs. 23.7%，P <0.001），以及每个住院患者的平均费用更高（1578.7 欧元 vs. 1324.4 欧元，P <0.001）。
患有癫痫和已登记精神障碍的住院患者增加了医疗保健资源的利用，这强调了在 PWE 中诊断和治疗精神障碍的重要性。
