The association of multiple chronic conditions and healthcare expenditures among adults with epilepsy in the United States.

Rationale: Epilepsy is a frequent neurologic condition with important financial strains on the US healthcare system. The co-occurrence of multiple chronic conditions (MCC) may have additional financial repercussions on this patient population. We aimed to assess the association of coexisting chronic conditions on healthcare expenditures among adult patients with epilepsy.

Decompressive hemicraniectomy for stroke by race/ethnicity in the United States.

Objective: Racial and ethnic differences in the performance of indicated neurosurgical procedures have been reported. However, it is not clear whether there are racial or ethnic differences in the performance of decompressive hemicraniectomy (DHC) for acute ischemic stroke. This study evaluated the rate, trends, and independent association of race and ethnicity with DHC among hospitalized ischemic stroke patients in the United States.

The Magnitude and Potential Causes of Sex Disparities in Statin Therapy in Veterans with Type 2 Diabetes: A 10-year Nationwide Longitudinal Cohort Study.

Background: Past research has shown that women eligible for statin therapy are less likely than their male counterparts to receive any statin therapy or be prescribed a statin at the guideline-recommended intensity. We compared statin treatment in men and women veterans from a national cohort of older veterans with type 2 diabetes.

Methods: The Veterans Health Administration Corporate Data Warehouse and Centers for Medicare and Medicaid Services data were used to create a unique dataset and perform a longitudinal study of veterans with type 2 diabetes from 2007 to 2016.

Early-hospital readmission after generalized status epilepticus during stroke hospitalization.

Objective: To assess the relationship between generalized convulsive status epilepticus (GCSE) during an index stroke hospitalization and occurrence of 30-day hospital readmission.

Methods: Retrospective analysis of data within the 2014 National Readmission Database, a national dataset tracking readmissions in the United States. We identified patients with an index discharge diagnosis of stroke using the International Classification of Disease, Ninth Revision, Clinical Modification (433.

Sudden cardiac arrest in epilepsy patients undergoing continuous video electroencephalogram monitoring: The national inpatient sample.

Objective: To examine the relationship between epilepsy and sudden cardiac arrest (SCA) and identify clinical and healthcare system related predictors of SCA in patients with a discharge diagnosis of epilepsy undergoing continuous video EEG (cVEEG) monitoring.

Methods: The national inpatient sample was used as data source to identify adults (18 years and older) with a primary discharge diagnosis of epilepsy who were at some point during their hospitalization on cVEEG monitoring. We applied a logistic regression model to identify independent patient-related and hospital/healthcare system-related factors associated with SCA.

Joint effect of race/ethnicity or location of residence and sex on low density lipoprotein-cholesterol among veterans with type 2 diabetes: a 10-year retrospective cohort study.

Background: Cardiovascular (CV) disease is the leading cause of death among United States women. Rural residence and ethnic-minority status are individually associated with increased CV mortality. Managing dyslipidemia is important in the prevention of CV mortality.

Association of seizure co-morbidity with early hospital readmission among traumatic brain injury patients.

Objective: To assess the frequency of seizure co-morbidity and its independent association with 30-day readmission rate among patients hospitalized with traumatic brain injury (TBI) in the United States.

Methods: The data source was the 2014 Nationwide Readmission Database. We included adults (Age ≥18 years) with a primary discharge diagnosis of TBI, identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 800.

Contemporary relationship between medical expenditures and quality of life among adults with epilepsy in the United States.

Aims: Epilepsy exacts substantial adverse economic and quality of life (QoL) costs. Clarifying the quantitative and qualitative relationships between total and out-of-pocket (OOP) healthcare expenditures and QoL could shed insights into how they influence each other, and have done so over recent times.

Methods: We used the Medical Expenditure Household Components 2003-2014 to identify a total of 2450 adults with epilepsy, representing a weighted population of 1,942,413.

An Evaluation of Statin Use Among Patients with Type 2 Diabetes at High Risk of Cardiovascular Events Across Multiple Health Care Systems.

Background: Patients with more than one chronic condition often receive care from several providers and facilities, which may lead to fragmentation of care. Poor care coordination in dual health care system use has been associated with increased emergency department visits, hospitalizations, and costs.

Objective: Dual health care system use is increasing among veterans, and we sought to evaluate the effect of dual health care system use on statin treatment in veterans with type 2 diabetes at high risk of cardiovascular events, using varying degrees of Centers for Medicare & Medicaid Services (CMS) services.

Trends in Medical Expenditures by Race/Ethnicity in Adults with Type 2 Diabetes 2002-2011.

Objective: The objective of the study was to examine racial/ethnic differences in medical expenditures (prescription, office-based, in-patient, out-patient, emergency room, total) over time, overall and by type of expenditure, in a nationally representative sample of adults with diabetes.

Methods: A weighted sample of 17,820,243 adults aged ≥18 with diabetes from the Medical Expenditure Panel Survey (MEPS) dataset from 2002 to 2011 were analyzed for this study. Multiple comparison testing and general linear model (GLM) were used to test for differences in expenditures by race.

Frequency and predictors of 30-day readmission after an index hospitalization for generalized convulsive status epilepticus: A nationwide study.

Objective: The objective of the study was to assess the frequency and factors associated with all-cause 30-day readmission among patients hospitalized with generalized convulsive status epilepticus (GCSE) in a nationwide sample in the United States.

Methods: We used The 2014 Nationwide Readmission Database (NRD) as the data source. We included adults (age ≥18 years) with a primary discharge diagnosis of GCSE, identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 345.

Trends in documented cannabis use disorder among hospitalized adult epilepsy patients in the United States.

Objective: Patients with epilepsy are at increased risk for mental health and substance abuse disorders. Given ongoing contemporary societal controversies about medicinal and recreational cannabis use, we aimed to ascertain recent nationwide prevalence, trends, and psychiatric diagnoses associated with cannabis use disorders (CUD) among epilepsy patients.

Methods: We interrogated the National Inpatient Sample database comprising a total of 398,936 adults (aged 18 years and above) with epilepsy between the years 2006 and 2014, identified using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 780.

Estimating the Economic Burden of Acute Myocardial Infarction in the US: 12 Year National Data.

Background: Acute myocardial infarction (AMI) carries a substantial mortality and morbidity burden. The purpose of this study is to provide annual mean cost per patient and national level estimates of direct and indirect costs (lost productivity from morbidity and premature mortality) associated with AMI.

Methods: Nationally representative data spanning 12 years (2003-2014) with a sample of 324,869 patients with AMI from the Medical Expenditure Panel Survey (MEPS) were analyzed.

Impact of Race and Location of Residence on Statin Treatment Among Veterans With Type 2 Diabetes Mellitus.

Rural residence and ethnic-minority status are individually associated with increased cardiovascular (CV) mortality. Statin therapy is known to reduce the risk of cardiovascular mortality. Although ethnic disparities in statin treatment exist, the joint impact of urban/rural residence and race/ethnicity on statin prescribing is unclear.

Racial/Ethnic Differences in Glycemic Control in Older Adults with Type 2 Diabetes: United States 2003-2014.

The aim of this study was to determine whether racial differences in HbA1c persist in older adults (≥65 years) living with type 2 diabetes. Data from The National Health and Nutrition Examination Survey (NHANES) 2003-2014 were used to examine the association between HbA1c and older adults (≥65 years) over time. Compared to non-Hispanic Whites, Mexican Americans had the greatest difference in average HbA1c among minority groups, followed by those with unspecified/mixed ethnicities and non-Hispanic Blacks.

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States.

Background: Compared with non-Hispanic Whites (NHW), racial-ethnic minorities bear a disproportionate burden of stroke and receive fewer evidence-based stroke care processes and treatments. Since 2015, mechanical thrombectomy (MT) has become standard of care for acute ischemic stroke (AIS) patients with proximal anterior circulation large vessel occlusion (LVO).

Objectives: Our objectives were to: assess recent trends in nationwide MT utilization among patients with AIS; determine if there were racial differences; and identify what factors were associated with such differences.

A contemporary and comprehensive analysis of the costs of stroke in the United States.

Background: While several studies have determined direct costs associated with stroke there is a paucity of research involving indirect costs, especially in younger patients.

Aim: Perform a cost of illness analysis for ischemic and non-traumatic hemorrhagic stroke in the US involving both direct and indirect costs in all age groups.

Methods: Nationally representative data was obtained from the Medical Expenditure Panel Survey (2003-2014).

Stroke Thrombectomy Utilization Rates by Sex: What were Things Like before 2015?

Background: Little is known about any potential sex disparities in access to mechanical thrombectomy (MT), including before the pivotal clinical trials establishing MT as a standard of care for acute ischemic stroke management.

Methods: All ischemic stroke patients included in the National Inpatient Sample between 2006 and 2014, were identified using the international classification of disease, Ninth Revision, Clinical Modification 433.X1, 434.

Influence of a Comorbid Diagnosis of Seizure on 30-Day Readmission Rates Following Hospitalization for an Index Stroke.

Objective: To examine the association of a comorbid seizure diagnosis with early hospital readmission rates following an index hospitalization for stroke in the United States.

Methods: Retrospective analysis of the 2014 National Readmission Database. The study population included adult patients (age >18 years old) with stroke, identified using the International Classification of Disease Ninth Revision, Clinical Modification (ICD-9-CM) codes 433.

Association of Prevalent Stroke with Hospitalization for Seizure: Patterns and Prognoses.

Introduction: Despite the close relationship between stroke and seizures, little is known about stroke trends and inpatient mortality among patients with seizures.

Materials And Methods: The National Inpatient Sample was used to analyze the prevalence and trends of stroke among patients discharged with a primary diagnosis of seizures between 2006 and 2014. International Classification of Diseases, Ninth Revision, Clinical Modification was used to identify patients discharged with a primary diagnosis of seizures and those with a secondary diagnosis of stroke.

Mortality and trends in stroke patients with seizures: A contemporary nationwide analysis.

Objective: Seizures are frequent among stroke patients. The goal of this study was to provide updated trends in seizures prevalence and mortality among hospitalized stroke patients.

Methods: Data from the National Inpatient Sample was used to estimate trends in seizures prevalence among stroke patients as well as mortality by seizures status, between 2006 and 2014.

Trends in Out-of-Pocket Burden in United States Adults with Kidney Disease: 2002-2011.

Background: High out-of-pocket (OOP) cost is a barrier to healthcare access and treatment compliance. Our study examined high OOP healthcare cost and burden trends in adults with kidney disease (KD).

Methods: Using Medical Expenditure Survey 2002-2011 data, we examined the proportion of people greater than 17 years old with KD whose OOP burden was high.