Jorge G Burneo1, Salimah Z Shariff2, Kuan Liu2, Sean Leonard2, Gustavo Saposnik2, Amit X Garg2. 1. From the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada. jburneo2@uwo.ca. 2. From the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada.
Abstract
OBJECTIVE: To assess the use of epilepsy surgery in patients with medically intractable epilepsy in a publicly funded universal health care system. METHODS: We performed a population-based retrospective cohort study using linked health care databases for Ontario, Canada, between 2001 and 2010. We identified all patients with medically intractable epilepsy, defined as those with seizures that did not respond to at least 2 adequate trials of seizure medications. We assessed the proportion of patients who had epilepsy surgery within the following 2 years. We further identified the characteristics associated with epilepsy surgery. RESULTS: A total of 10,661 patients were identified with medically intractable epilepsy (mean age 47 years, 51% male); most (74%) did not have other comorbidities. Within 2 years of being defined as medically intractable, only 124 patients (1.2%) underwent epilepsy surgery. Death occurred in 12% of those with medically intractable epilepsy. Those who underwent the procedure were younger and had fewer comorbidities compared to those who did not. CONCLUSION: In our setting of publicly funded universal health care, more than 10% of patients died within 2 years of developing medically intractable epilepsy. Epilepsy surgery may be an effective treatment for some patients; however, fewer than 2% of patients who may have benefited from epilepsy surgery received it.
OBJECTIVE: To assess the use of epilepsy surgery in patients with medically intractable epilepsy in a publicly funded universal health care system. METHODS: We performed a population-based retrospective cohort study using linked health care databases for Ontario, Canada, between 2001 and 2010. We identified all patients with medically intractable epilepsy, defined as those with seizures that did not respond to at least 2 adequate trials of seizure medications. We assessed the proportion of patients who had epilepsy surgery within the following 2 years. We further identified the characteristics associated with epilepsy surgery. RESULTS: A total of 10,661 patients were identified with medically intractable epilepsy (mean age 47 years, 51% male); most (74%) did not have other comorbidities. Within 2 years of being defined as medically intractable, only 124 patients (1.2%) underwent epilepsy surgery. Death occurred in 12% of those with medically intractable epilepsy. Those who underwent the procedure were younger and had fewer comorbidities compared to those who did not. CONCLUSION: In our setting of publicly funded universal health care, more than 10% of patients died within 2 years of developing medically intractable epilepsy. Epilepsy surgery may be an effective treatment for some patients; however, fewer than 2% of patients who may have benefited from epilepsy surgery received it.
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Epidemiology Date: 2007-11 Impact factor: 4.822
Authors: Nathalie Jette; Hude Quan; Jose F Tellez-Zenteno; Sophia Macrodimitris; Walter J Hader; Elisabeth M S Sherman; Lorie D Hamiwka; Elaine C Wirrell; Jorge G Burneo; Amy Metcalfe; Peter D Faris; Lizbeth Hernandez-Ronquillo; Churl-Su Kwon; Andrew Kirk; Samuel Wiebe Journal: Neurology Date: 2012-08-15 Impact factor: 9.910
Authors: Jerome Engel; Michael P McDermott; Samuel Wiebe; John T Langfitt; John M Stern; Sandra Dewar; Michael R Sperling; Irenita Gardiner; Giuseppe Erba; Itzhak Fried; Margaret Jacobs; Harry V Vinters; Scott Mintzer; Karl Kieburtz Journal: JAMA Date: 2012-03-07 Impact factor: 56.272
Authors: Patrick Kwan; Alexis Arzimanoglou; Anne T Berg; Martin J Brodie; W Allen Hauser; Gary Mathern; Solomon L Moshé; Emilio Perucca; Samuel Wiebe; Jacqueline French Journal: Epilepsia Date: 2009-11-03 Impact factor: 5.864
Authors: Jorge G Burneo; Nathalie Jette; William Theodore; Charles Begley; Karen Parko; David J Thurman; Samuel Wiebe Journal: Epilepsia Date: 2009-09-03 Impact factor: 5.864
Authors: Chloe E Hill; Chun Chieh Lin; James F Burke; Kevin A Kerber; Lesli E Skolarus; Gregory J Esper; Brandon Magliocco; Brian C Callaghan Journal: Neurology Date: 2019-01-23 Impact factor: 9.910
Authors: Jason R Smith; Felipe J S Jones; Brandy E Fureman; Jeffrey R Buchhalter; Susan T Herman; Neishay Ayub; Christopher McGraw; Sydney S Cash; Daniel B Hoch; Lidia M V R Moura Journal: Epilepsy Res Date: 2020-07-11 Impact factor: 3.045
Authors: Lorenzo Caciagli; Andrea Bernasconi; Samuel Wiebe; Matthias J Koepp; Neda Bernasconi; Boris C Bernhardt Journal: Neurology Date: 2017-07-07 Impact factor: 9.910
Authors: Yanrong Zhang; Haiyan Zhou; Haibo Qu; Chengde Liao; Hong Jiang; Siqin Huang; Sara Natasha Ghobadi; Arsenii Telichko; Ningrui Li; Frezghi G Habte; Tim Doyle; James P Woznak; Edward H Bertram; Kevin S Lee; Max Wintermark Journal: Ultrasound Med Biol Date: 2020-02-17 Impact factor: 2.998