从儿童到成人癫痫治疗过渡的过程和预测因素：一项单一机构的回顾性研究

IF 2.1 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-07-28 DOI:10.1016/j.pediatrneurol.2025.07.015

Jasmine Sondhi MD , Esraa Ali MBBS , Krishna Trivedi MD , Stephanie DeCarvalho DO , Traci M. Kazmerski MD, MS , Laura Kirkpatrick MD

{"title":"从儿童到成人癫痫治疗过渡的过程和预测因素：一项单一机构的回顾性研究","authors":"Jasmine Sondhi MD , Esraa Ali MBBS , Krishna Trivedi MD , Stephanie DeCarvalho DO , Traci M. Kazmerski MD, MS , Laura Kirkpatrick MD","doi":"10.1016/j.pediatrneurol.2025.07.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To characterize transition of care processes for patients with epilepsy in a single institution without a formal epilepsy transition of care program.</div></div><div><h3>Methods</h3><div>We reviewed medical records for individuals with epilepsy who were at least 15 years old seen outpatient by pediatric neurology in 2019. We followed their records through 2022. We evaluated whether they had documentation of transition discussion, if they transferred to adult care, and/or if they were retained in adult care. Excluding individuals who died or were discharged, we performed logistic regression for transition discussion, transfer, and retention, adjusting for sex, age, race/ethnicity, distance from institution, zip code median household income, rurality, drug-resistant epilepsy (DRE), intellectual disability (ID), and technology dependence.</div></div><div><h3>Results</h3><div>We evaluated documentation for 274 individuals (50% female, median age 18 years, 84% white, 1.5% Hispanic, 24% DRE, 25% ID). Excluding 14 who died and 28 who were discharged, 57 of 226 (25%) had a documented transition discussion and 115 (51%) transitioned (median age 20 years). Of 95 eligible individuals, 77 (81%) were retained in adult care. Predictors of transition discussion included older age (aOR: 1.44, 95% confidence interval: 1.22, 1.70) and absence of ID (aOR: 4.17 [1.51, 11.11]). Predictors of transfer included older age (aOR: 1.19 [1.02, 1.39]), documented transition discussion (aOR: 3.25 [1.48, 7.13]), and DRE (aOR: 2.41 [1.10, 5.28]). We identified no significant predictors of retention.</div></div><div><h3>Conclusions</h3><div>Discussion of transition may promote transfer to adult care among people with epilepsy. Formal transition programs may be needed to optimize care processes.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"171 ","pages":"Pages 80-85"},"PeriodicalIF":2.1000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Processes and Predictors in the Transition From Pediatric to Adult Epilepsy Care: A Retrospective Study at a Single Institution\",\"authors\":\"Jasmine Sondhi MD , Esraa Ali MBBS , Krishna Trivedi MD , Stephanie DeCarvalho DO , Traci M. Kazmerski MD, MS , Laura Kirkpatrick MD\",\"doi\":\"10.1016/j.pediatrneurol.2025.07.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To characterize transition of care processes for patients with epilepsy in a single institution without a formal epilepsy transition of care program.</div></div><div><h3>Methods</h3><div>We reviewed medical records for individuals with epilepsy who were at least 15 years old seen outpatient by pediatric neurology in 2019. We followed their records through 2022. We evaluated whether they had documentation of transition discussion, if they transferred to adult care, and/or if they were retained in adult care. Excluding individuals who died or were discharged, we performed logistic regression for transition discussion, transfer, and retention, adjusting for sex, age, race/ethnicity, distance from institution, zip code median household income, rurality, drug-resistant epilepsy (DRE), intellectual disability (ID), and technology dependence.</div></div><div><h3>Results</h3><div>We evaluated documentation for 274 individuals (50% female, median age 18 years, 84% white, 1.5% Hispanic, 24% DRE, 25% ID). Excluding 14 who died and 28 who were discharged, 57 of 226 (25%) had a documented transition discussion and 115 (51%) transitioned (median age 20 years). Of 95 eligible individuals, 77 (81%) were retained in adult care. Predictors of transition discussion included older age (aOR: 1.44, 95% confidence interval: 1.22, 1.70) and absence of ID (aOR: 4.17 [1.51, 11.11]). Predictors of transfer included older age (aOR: 1.19 [1.02, 1.39]), documented transition discussion (aOR: 3.25 [1.48, 7.13]), and DRE (aOR: 2.41 [1.10, 5.28]). We identified no significant predictors of retention.</div></div><div><h3>Conclusions</h3><div>Discussion of transition may promote transfer to adult care among people with epilepsy. Formal transition programs may be needed to optimize care processes.</div></div>\",\"PeriodicalId\":19956,\"journal\":{\"name\":\"Pediatric neurology\",\"volume\":\"171 \",\"pages\":\"Pages 80-85\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0887899425002176\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric neurology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0887899425002176","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的探讨在没有正式癫痫过渡护理方案的单一机构中癫痫患者护理过程的特点。方法我们回顾了2019年儿科神经病学门诊至少15岁的癫痫患者的医疗记录。我们跟踪了他们的记录直到2022年。我们评估了他们是否有过渡讨论的记录，他们是否转移到成人护理，和/或他们是否留在成人护理中。排除死亡或出院的个体，我们对转移讨论、转移和保留进行了logistic回归，调整了性别、年龄、种族/民族、与机构的距离、邮政编码、家庭收入中位数、农村、耐药癫痫（DRE）、智力残疾（ID）和技术依赖。结果我们评估了274例患者的文献资料（50%为女性，中位年龄18岁，84%为白人，1.5%为西班牙裔，24%为DRE， 25%为ID）。除去14例死亡和28例出院的患者，226例患者中有57例（25%）有变性讨论记录，115例（51%）变性（中位年龄20岁）。在95名符合条件的个体中，77名（81%）被保留在成人护理中。预测因素包括年龄较大（aOR: 1.44, 95%可信区间：1.22,1.70）和缺乏ID （aOR: 4.17[1.51, 11.11]）。迁移的预测因素包括年龄较大（aOR: 1.19[1.02, 1.39]）、有文献记载的迁移讨论（aOR: 3.25[1.48, 7.13]）和DRE （aOR: 2.41[1.10, 5.28]）。我们没有发现留存率的显著预测因子。结论对过渡的讨论可促进癫痫患者向成人护理的转移。可能需要正式的过渡方案来优化护理过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Processes and Predictors in the Transition From Pediatric to Adult Epilepsy Care: A Retrospective Study at a Single Institution

Objective

To characterize transition of care processes for patients with epilepsy in a single institution without a formal epilepsy transition of care program.

Methods

We reviewed medical records for individuals with epilepsy who were at least 15 years old seen outpatient by pediatric neurology in 2019. We followed their records through 2022. We evaluated whether they had documentation of transition discussion, if they transferred to adult care, and/or if they were retained in adult care. Excluding individuals who died or were discharged, we performed logistic regression for transition discussion, transfer, and retention, adjusting for sex, age, race/ethnicity, distance from institution, zip code median household income, rurality, drug-resistant epilepsy (DRE), intellectual disability (ID), and technology dependence.

Results

We evaluated documentation for 274 individuals (50% female, median age 18 years, 84% white, 1.5% Hispanic, 24% DRE, 25% ID). Excluding 14 who died and 28 who were discharged, 57 of 226 (25%) had a documented transition discussion and 115 (51%) transitioned (median age 20 years). Of 95 eligible individuals, 77 (81%) were retained in adult care. Predictors of transition discussion included older age (aOR: 1.44, 95% confidence interval: 1.22, 1.70) and absence of ID (aOR: 4.17 [1.51, 11.11]). Predictors of transfer included older age (aOR: 1.19 [1.02, 1.39]), documented transition discussion (aOR: 3.25 [1.48, 7.13]), and DRE (aOR: 2.41 [1.10, 5.28]). We identified no significant predictors of retention.

Conclusions

Discussion of transition may promote transfer to adult care among people with epilepsy. Formal transition programs may be needed to optimize care processes.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.