OBJECTIVES

: To describe incidence of status epilepticus (SE), patient’s characteristics, and outpatient antiepileptic drug treatment after hospital discharge after a SE event among insured by a regional German public sickness fund (Saxony/Thuringia).

METHODS

: We used an anonymized claims database covering the period 2010-2016. The analyzed study population consisted of all patients with a hospitalization with SE diagnosis (ICD-10 G41.-) between 01/01/2011-31/12/2015. Patient observation started at date of first observed hospitalization due to SE and lasted 12 months or until death of patients, baseline period was 12 months before index. Descriptive statistical analyses were conducted. Incidence of SE, characteristics and etiology as well as anticonvulsive treatment before and after SE were analyzed.

RESULTS

: We identified 4,128 patients with SE (mean age 66.5 years, 53.8% female). Age-standardized incidence (German standard) was 25.5 per 100,000 person-years. Main etiologic factors were remote (with hospitalization 7 days-1 year before SE)/acute (with hospitalization<7 days before or at SE) epilepsy (16.4/9.6%), remote/acute trauma (12.7/3.5%), and remote/acute stroke (10.4/8.1%). 2,532 patients (61.3%) of all SE patients had at least one epilepsy diagnosis in the baseline, 3,342 (81.0%) in the follow-up period. Before and after SE, most frequently outpatient prescribed AEDs were Levetiracetam (19.3/45.2%), Valproic acid (14.4/24.3%), Lamotrigine (7.2/11.4%), Lacosamide (2.9/10.1%), and Lorazepam (5.5/8.8%). However, 548 patients (15.9%) who survived index hospitalization, did not receive any outpatient AED treatment in the 12 months after index SE diagnosis, that includes 172 of patients with an epilepsy diagnosis in baseline (6.8%). 1,641 of all SE patients died within 12 months (39.8%), 680 (16.5%) died during index hospitalization.

CONCLUSIONS

: A substantial percentage of SE patients died within the 12 months after SE. Reasons why a substantial proportion of SE patients do not receive any outpatient AED treatment after hospital discharge require further research.