Abstracts

Rationale: Status epilepticus is a neurological emergency with high morbidity and mortality. Along with sudden unexplained death in epilepsy (SUDEP), it represents a unique leading cause of death in patients with epilepsy. Understanding mortality trends in status epilepticus is thus critical to reducing mortality in epilepsy. The goal of this project is to evaluate demographic trends in status epilepticus mortality over the last two decades.


Methods: With this retrospective cohort, we used data from the Centers for Disease Control and Prevention’s (CDC) Wide-ranging Online Data for Epidemiologic Research tool. Queries were designed to extract crude death rates per 100,000 persons using ICD-10 and ICD-9 codes for Status Epilepticus by year from 1999-2020. Additionally, the queries were subdivided by demographic variables including race and ethnicity (White, Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaska Native) and age groups (0-24, 25-49, 50-74, and 75 and older). Crude rates were adjusted using 2010 US census data to age-standardize the mortality rates. Annual rates and 95% confidence intervals were analyzed and graphed using Jointpoint Regression Program. Certain years were excluded from analysis for specific populations s with less than 10 annual deaths due to patient confidentiality.


Results: From 1999 to 2020, there were 16,455 deaths from status epilepticus in the US. Of the most notable trends, there was nearly a 2-fold increase in adjusted-mortality rate per 100,000 from 1999 to 2020 amongst all groups (0.13 (95% CI 0.11-0.15) in 1999 to 0.25 (95% CI 0.23-0.27) in 2020, p-value for increase over time < 0.001). The most recent mortality rates were highest in the Black or African American group (0.95 per 100,000, 95% CI 0.43-1.47) and American Indian or Alaskan Native groups (0.97 per 100,000, 95% CI 0.17-1.77). Rates were highest in the age 75 and older group.


Conclusions: To date, there is sparse detailed analysis of the annual trends of status epilepticus in the United States, and this analysis supports a significant increase in the annual mortality rate in the past 2 decades. Causes for this increase may be due to increases observed specifically in the oldest age group, and to high rates especially amongst minoritized populations. This analysis provides useful public health information, and also warrants further investigation into the underlying processes contributing to these elevated rates of death due to status epilepticus.


Funding: There was no funding received in support of this abstract.