Survival Analysis of Accidents Confirms Reduction After Surgery in a Group of 439 Individuals with Temporal Lobe Epilepsy and Hippocampal Atrophy (P2-1.011)

Abstract

<h3>Objective:</h3> To compare the frequency of accidents in patients with MTLE undergoing clinical and surgical treatments. <h3>Background:</h3> Patients with Epilepsy have a greater risk of accidents (i.e., falls and burns), which associates with high morbidity. The causes are multifactorial. Mesial Temporal Lobe Epilepsy (MTLE) is recognized for being pharmacoresistant, therefore, with a greater risk of accidents. Unfortunately, few studies have evaluated the impact of surgical treatment for MTLE on the frequency of accidents. <h3>Design/Methods:</h3> This is a retrospective, non-randomized study. Data from both groups were collected from the medical records of individuals from outpatient Epilepsy Clinics of UNICAMP. We searched for data related to falls, burnings, fractures, head trauma, and car accidents. We used SPSS with chi-square and Fisher’s exact tests to analyze categorical variables and survival analysis (Kaplan Meier) to evaluate the time between the beginning of follow-up and the event’s occurrence. We further applied Log Rank and Breslow tests to compare groups. <h3>Results:</h3> Accidents were more frequent in the clinical group (37 [15.3%]) when compared to the surgical one (9 [4,6%]) [p&lt;0,001]. During the follow-up (median interval of 17 years [DP 6.78] in the clinical group; 8.6 years [DP 5.41] in the surgical group), 95.4% of the surgical patients were free of accidents, while in the clinical group, 84.7% [p=0.02]. Falls were more frequent in the clinical group (90 [37.2%]) than in the surgical one (15 [7.6%]) [p&lt;0.001]. The survival analyses confirmed that falls occurred in 36% of the clinical group over time compared to 8% in the surgical group [p&lt;0,001]. <h3>Conclusions:</h3> Surgical treatment in pharmacoresistant TLE may have an essential role in accident prevention. Therefore, early surgery should be considered, given the positive impact on their quality of life and possible avoidance of serious injuries. <b>Disclosure:</b> Miss Dias has received research support from CAPES. Miss Dias has received research support from FAPESP. Ms. Ribeiro has nothing to disclose. Lucas Silva has nothing to disclose. Prof. João has received research support from FAPESP. Dr. Alvim has nothing to disclose. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Biopharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for United Medical – Brazil. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Zodiac Pharma . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eurofarma – Brazil . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology - Epilepsy. The institution of Dr. Cendes has received research support from São Paulo Research Foundation - FAPESP. The institution of Dr. Cendes has received research support from Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil . The institution of Dr. Cendes has received research support from NIH. Clarissa Yasuda has nothing to disclose.