Epilepsy Surgery in Older Adults: A Systematic Review and Meta-Analysis
Abstract number :
2.361
Submission category :
16. Epidemiology
Year :
2021
Submission ID :
1826104
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Arielle Vary-O'Neal, BA, BSc - Université de Montréal; Ishak Tamani - Université de Montréal; Christian Mendo, MSc - Public Health - Université de Montréal; Jorge Burneo, MD, MSc - Department of Epidemiology and Biostatistics, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry - Western University; David Steven, MD, MPH, FRCSC, FACS - Department of Epidemiology and Biostatistics, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry - Western University; Mark Keezer - MDCM, PhD, Neurosciences, Université de Montréal
Rationale: Despite the general safety and efficacy of epilepsy surgery, there is evidence that it remains underutilized. Although there are an increasing number of studies reporting epilepsy surgery in older adults, there is no consensus on whether epilepsy surgery is efficacious or safe for this population. Our objective is to systematically assess the efficacy as well as safety of resective surgery in people aged 50 years or older with drug-resistant epilepsy.
Methods: We considered studies that examine the epilepsy surgery in adults aged 50 years and older. Study eligibility was limited to studies carried out after 1990, with a minimum of 10 participants and 6 months of follow-up. We searched the following databases for published studies: Ovid MEDLINE, Ovid EMBASE, CINAHL, PsychInfo, and Web of Science CPCI-S. The risk of bias of each included study was independently assessed by two reviewers using the Methodological Index for Non-Randomized Studies (MINORS) instrument.
Results: 16 retrospective studies met the criteria for inclusion, for a total of 734 older adults who underwent epilepsy surgery (along with 3,527 adults younger than 50 years as control groups). Preliminary analyses show that 65.7% (95% CI: 61.0, 70.3) of older adults are seizure-free at last follow-up. This compares favorably to 70.4% (95% CI: 65.8, 74.9) seen with younger adults.
Conclusions: There remains controversy about the efficacy and tolerability of this potentially curative procedure among older adults. Analyses that we will shortly complete will examine the risk of important post-operative sequelae among older adults following epilepsy surgery. We also aim to identify whether there are any subpopulations of older adults that are at particular risk for these sequelae.
Funding: Please list any funding that was received in support of this abstract.: None.
Epidemiology