Mortality Risk and Risk Factors in Patients with Posttraumatic Epilepsy: A Population-Based Cohort Study

Wei-Jun Lin, Tomor Harnod, Cheng-Li Lin and Chia-Hung Kao
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Wei-Jun Lin: Department of Emergency, China Medical University Hospital, Taichung 404, Taiwan
Tomor Harnod: Department of Neurosurgery, Hualien Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
Cheng-Li Lin: Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
Chia-Hung Kao: Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan

IJERPH, 2019, vol. 16, issue 4, 1-10

Abstract: Aim: Use the National Health Insurance Research Database of Taiwan to determine whether patients with posttraumatic epilepsy (PTE) have an increased risk of mortality. Methods: Patients ≥20 years old ever admitted because of head injury (per International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 850–854 and 959.01) during 2000–2012 were enrolled into a traumatic brain injury (TBI) cohort. The TBI cohort was divided into with PTE (ICD-9-CM code 345) and posttraumatic nonepilepsy (PTN) cohorts. We compared the PTE and PTN cohorts in terms of age, sex, and comorbidities. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of all-cause mortality risk in these cohorts. Results: Patients with PTE had a higher incidence rate (IR) of mortality than did patients with TBI alone (IR per 1000 person-years: 71.8 vs. 27.6), with an aHR 2.31 (95% CI = 1.96–2.73). Patients with PTE aged 20–49, 50–64, and ≥65 years had, respectively, 2.78, 4.14, and 2.48 times the mortality risk of the PTN cohort. Patients with any comorbidity and PTE had 2.71 times the mortality risk as patients in the PTN cohort. Furthermore, patients with PTE had 28.2 increased hospital days and 7.85 times as frequent medical visits per year compared with the PTN cohort. Conclusion: Taiwanese patients with PTE had approximately 2 times the mortality risk and an increased medical burden compared to patients with TBI only. Our findings provide crucial information for clinicians and the government to improve TBI outcomes.

Keywords: cohort study; mortality; National Health Insurance; posttraumatic epilepsy; traumatic brain injury (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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