Estimating the cost of admissions related to convulsive status epilepticus in the United States of America

Abstract

PurposeTo estimate the cost of admissions related to status epilepticus (SE) in the USA and to evaluate SE mortality. MethodDescriptive retrospective study using national estimates from the KID’s Inpatient Database (KID) for children and from the National Inpatient Sample (NIS) for adults for the years 2007–2012, the largest collection of all-payer, encounter-level hospital care data in the United States. The individual observation in this study is hospital admission. ResultsFrom a population of 186,013,640 admissions, a total of 184,500 admissions were related to SE. The median (p25-p75) cost of admissions related to SE was $7690 ($3893–$17,247) in the KID 2010–2012, $6529 ($3,370–$14,854) in the KID 2007–2009, $13,874 ($6699–$29,176) in the NIS 2012, $13,313 ($6,483–$28,598) in the NIS 2011, $12,999 ($6,366–$27,505) in the NIS 2010, $11,833 ($5721–$24,657) in the NIS 2009, $11,479 ($5,611–$24,326) in the NIS 2008, and $10,759 ($5493–$22,928) in the NIS 2007. Costs were more than two times higher for super-refractory SE admissions than for refractory SE admissions. Costs stratified by age followed an “U”-shaped distribution with higher costs in admissions of young children and older adults. Mortality ranged from 2.5% to 3% in children and from 12.7% to 14.9% in adults. ConclusionsThis study estimates the cost of admissions related to SE in the USA to be approximately $7000 in children and $13,000 in adults, and quantifies how costs markedly increase once SE becomes super-refractory.