日本儿童癫痫的流行病学和实际管理：利用健康索赔数据库进行的描述性研究。

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Epilepsy Research Pub Date : 2024-09-30 DOI:10.1016/j.eplepsyres.2024.107455

Takashi Saito , Nozomi Miyagawa , Kyoko Kanazawa , Masaki Iwasaki , Eiji Nakagawa

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引用次数: 0

摘要

简介：这项流行病学研究旨在评估儿童癫痫的患病率、合并症和实际管理情况，为加强癫痫管理和医疗资源规划提供见解：该研究涵盖了截至 2018 年 12 月年龄在 0-17 岁的被保险人，他们在 2018 年的任何时间点都在日本健康索赔数据库中进行了登记，时间跨度为 2018 年 1 月至 12 月，至少在这一年的部分时间内进行了登记。癫痫的定义是根据《国际疾病分类》第 10 次修订版的代码诊断为癫痫，且索赔的癫痫管理费或抗癫痫药物（ASM）处方超过 4 周。对癫痫患病率、患者特征（包括合并症）和管理状况（如抗癫痫药物处方）进行了评估：在 1528905 名登记儿童中，有 9279 人被确认患有癫痫。0-2 岁年龄组的癫痫发病率最低，为每千人 1.97 例（95 % 置信区间 [CI] 1.80-2.15），随着年龄的增长，15-17 岁年龄组的发病率增至每千人 9.34 例（95 % 置信区间 [CI] 8.98-9.72），≥12 岁年龄组的男孩发病率明显高于女孩。88.3%-91.9% 的患者服用了 ASM。此外，27 名（0.29%）患者接受了癫痫手术。随着年龄的降低，要求静脉注射 ASMs 和长期脑电图费用的频率也在增加：我们的研究结果表明，幼儿比青少年获得了更多的医疗资源，而癫痫手术却未得到充分利用。进一步的调查将有助于改善癫痫的管理和制定防治措施。

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Epidemiology and real-world management of childhood epilepsy in Japan: A descriptive study using a health claim database

Introduction

The purpose of this epidemiological study was to assess the prevalence, comorbidities, and real-world management of childhood epilepsy to provide insights for enhancing epilepsy management and medical resource planning.

Materials and methods

The study encompassed insured individuals aged 0–17 years as of December 2018 who were registered at any point in 2018, for at least part of the year, in a Japanese health claims database spanning January—December 2018. Epilepsy was defined as a diagnosis of epilepsy based on the International Classification of Diseases, 10th Revision codes, and a claimed management fee for epilepsy or an anti-seizure medication (ASM) prescription for longer than 4 weeks. The prevalence of epilepsy, patient characteristics, including comorbidities, and management status, such as prescription of ASMs, were evaluated.

Results

Among 1528,905 registered children, 9279 were identified as having epilepsy. The prevalence of epilepsy was the lowest at 1.97 per 1000 population (95 % confidence interval [CI] 1.80–2.15) in the 0–2-year age group and increased with age to 9.34 per 1000 population (95 % CI 8.98–9.72) in the 15–17-year age group, with a significantly higher prevalence in boys than in girls in the ≥12-year age group. ASMs were prescribed to 88.3 %–91.9 % of the patients. Moreover, 27 (0.29 %) patients underwent epilepsy surgery. The frequency of claiming intravenous ASMs and long-term electroencephalogram fees increased with a decrease in age.

Conclusions

Our findings indicate that young children receive more medical resources than adolescents and that epilepsy surgery is underutilized. Further investigations will help improve the management of and develop measures against epilepsy.

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来源期刊

Epilepsy Research 医学-临床神经学

CiteScore

0.10

自引率

4.50%

发文量

143

审稿时长

62 days

期刊介绍： Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.