Epidemiology and Burden of Illness of Lennox-Gastaut Syndrome in Taiwan: A Retrospective Cohort Study.

IF 2 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Risk Management and Healthcare Policy Pub Date : 2025-09-20 eCollection Date: 2025-01-01 DOI:10.2147/RMHP.S519367

Avery Shuei-He Yang, Daniel Hsiang-Te Tsai, Li-Wen Chen, Wen-Mei Cheng, Chu Chiao Wang, Shih-Chieh Shao, Wendy Wenjie Song, Mahsa H Kouhkamari, Wei-Ching Huang, Sally Bowditch, Edward Chia-Cheng Lai

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引用次数: 0

Abstract

Purpose: Examine the epidemiology and burden of illness of patients with Lennox-Gastaut syndrome (LGS) in Taiwan.

Methods: The National Health Insurance Database (NHID) was used, complemented by the Chang Gung Research Database (CGRD). Confirmed LGS was defined by International Classification of Diseases-10 (ICD-10) LGS codes or ≥1 rufinamide prescription; probable LGS was defined as patients aged ≤10 years when receiving ≥3 antiseizure medications (ASMs), with ICD-9/10 codes for developmental delay. Independent clinical review/validation of all LGS cases in the CGRD was conducted. Prevalence, incidence, time to treatment/LGS diagnosis, hospitalizations, costs (US dollars), ASM usage, and mortality were assessed. For the NHID, a positive predicted value (PPV) was calculated from the CGRD validation step to adjust prevalence/incidence estimates.

Results: In the NHID, 190 patients with confirmed LGS were identified. In 2018, PPV-adjusted prevalence was 2.4, 0.6, and 10.2 per 100,000 people and PPV-adjusted incidence was 0.6, 0.2, and 2.4 per 100,000 person-years in the total, adult, and pediatric populations, respectively. Of 92 (48%) hospitalized patients, 22 (24%) had ≥3 hospitalizations/year. Mean (standard deviation [SD]) time to treatment and LGS diagnosis were 12.3 (26.5) and 110.1 (54.7) months. Mean length of stay was around 12 days. Most hospitalizations (96%) were epilepsy related. Mean (SD) hospitalization cost was $237 ($216) per day. Mean (SD) total inpatient and outpatient costs were $5800 ($817) and $2667 ($132), respectively, per patient per year (PPPY); medication in hospital and ASM costs were $1910 ($108) and $1614 ($93) PPPY. Most prescribed ASMs were valproate (89%), levetiracetam (83%), clonazepam (69%), clobazam (68%), and topiramate (65%). Mortality was 0.01 deaths per 100,000 people in 2018.

Conclusion: Although prevalence and incidence of LGS in Taiwan were lower than in other countries, the multifaceted burden of illness in LGS is highlighted herein. Reduced hospitalizations through better epilepsy control may reduce LGS expenditure.

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台湾lenox -胃肠综合征的流行病学与疾病负担：一项回顾性队列研究。

目的：探讨台湾lenox - gastaut综合征（LGS）患者的流行病学及疾病负担。方法：采用国家健康保险数据库（NHID），并辅以长庚研究数据库（CGRD）。确认LGS符合国际疾病分类-10 (ICD-10) LGS代码或≥1个鲁非胺处方；可能LGS定义为年龄≤10岁且接受≥3种抗癫痫药物（asm）治疗的患者，并符合ICD-9/10发育迟缓编码。对CGRD中所有LGS病例进行了独立的临床审查/验证。评估了患病率、发病率、治疗时间/LGS诊断、住院、费用（美元）、ASM使用和死亡率。对于NHID，从CGRD验证步骤计算阳性预测值（PPV）以调整患病率/发病率估计。结果：在NHID中，确认了190例LGS患者。2018年，ppv调整后的患病率分别为每10万人2.4、0.6和10.2人，ppv调整后的发病率分别为每10万人年0.6、0.2和2.4人。92例（48%）住院患者中，22例（24%）住院≥3次/年。治疗和LGS诊断的平均（标准差[SD]）时间分别为12.3（26.5）和110.1（54.7）个月。平均住院时间约为12天。大多数住院（96%）与癫痫有关。平均（SD）住院费用为237美元/天（216美元）。平均（SD）住院和门诊总费用分别为每位患者每年5800美元（817美元）和2667美元（132美元）（PPPY）；住院药物和ASM费用分别为1910美元（108美元）和1614美元（93美元）。最常用的镇静药是丙戊酸钠（89%）、左乙拉西坦（83%）、氯硝西泮（69%）、氯巴唑仑（68%）和托吡酯（65%）。2018年死亡率为每10万人死亡0.01人。通过更好的癫痫控制减少住院可能会减少LGS支出。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Risk Management and Healthcare Policy Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.20

自引率

2.90%

发文量

242

审稿时长

16 weeks

期刊介绍： Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include: Public and community health Policy and law Preventative and predictive healthcare Risk and hazard management Epidemiology, detection and screening Lifestyle and diet modification Vaccination and disease transmission/modification programs Health and safety and occupational health Healthcare services provision Health literacy and education Advertising and promotion of health issues Health economic evaluations and resource management Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.