Authors :
Presenting Author: Herman Li, BS – University of Rochester School of Medicine and Dentistry
Derek George, MD – University of Rochester Medical Center
Keshov Sharma, MD, PhD – University of Rochester Medical Center
Webster Pilcher, MD, PhD – University of Rochester Medical Center
Andrew Wensel, MD – University of Rochester Medical Center
Thomas Wychowski, MD – University of Rochester Medical Center
Melissa LoPresti, MD, MPH – , University of Rochester Medical Center/ Golisano Children’s Hospital
Rationale:
Quantify utilization trends of DBS/RNS and impact of DBS/RNS on re-admission for seizures and ASM prescriptions. We hypothesized that CBS and DBS are associated with decreased re-admission for uncontrolled seizures and result in decreased ASM prescriptions. Methods:
The Epic Cosmos database is a collaboration with a community of Epic Health systems representing more than 300 million patient records across more than 1400 hospitals and 40,000 clinics from the US, Canada, Lebanon, and Saudi Arabia. The database was queried for patients (≥18 years of age and < 18 years of age) with ICD-10 coded diagnoses of intractable focal, generalized, and unspecified epilepsy (G40.109, G40.111, G40.209, G40.211, G40.019, G40.319, G40.311, G40.419, G40.411, G40.804, G40.803, G40.919, G40.911) who underwent RNS/DBS from January 1, 2016, to April 10, 2024. Utilization of CBS and DBS for intractable epilepsy was quantified based on CPT codes (61850, 61860, 61863, 61864, 61885, 61886). Number of inpatient admissions due to patients’ respective type of intractable epilepsy was quantified up to 12 months before or after surgery. Procedural trends and complications of CBS and DBS in pediatric and adult populations were quantified. ASM prescription trends were also quantified and compared between cortical and depth electrodes. Descriptive and inferential statistics were used to compare re-admission rates pre/post-surgery and ASM prescription volumes based on electrode type, with alpha < 0.05 denoting statistical significance.