Tapan Kavi1, Ephrem Teklemariam2, John Gaughan3, Christa Schorr4. 1. Departments of Neurology and Neurosurgery-Neurocritical Care. 2. Neurology. 3. Biostatistics. 4. Critical Care, Cooper University Hospital, Camden, NJ.
Abstract
BACKGROUND AND PURPOSE: Data regarding the incidence of seizures in patients diagnosed with fat embolism syndrome (FES) are lacking. We examined the incidence of seizures in patients with FES, and the impact of seizures on outcomes over a 10-year period. METHODS: Using the National Inpatient Sample data set we identified adults (age 18 y old or above) with a diagnosis of FES (ICD-9 958.1) between 2005 and 2014, and categorized them according to the presence or absence of seizures. We excluded patients with a history of epilepsy or traumatic brain injury RESULTS: : Of the 66,227,531 discharges, we identified 1888 patients (0.003%) with FES of which 53% were male and mean age of 56 (±57.45). Seizure or epilepsy rate in patients with FES was 2.86% (1.69% with seizures and 1.16% with epilepsy), as compared with 3.6% in all hospitalized patients without FES. The Charlson Comorbidity Index for all FES patients was 2.38 (±5.28) and was similar for those with and without seizures. Hospital length of stay was higher in patients with FES and seizures versus those without seizures (14.59 vs. 10.82 d, P=0.09). No statistically significant difference in mortality was observed between the 2 groups. CONCLUSIONS: The rate of seizure and epilepsy in patients with FES is low when compared with rates in all hospitalized patients or in patients with other causes of acute neurological injury such as intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury. Further studies are needed to provide recommendations for antiepileptic medication use in FES.
BACKGROUND AND PURPOSE: Data regarding the incidence of seizures in patients diagnosed with fat embolism syndrome (FES) are lacking. We examined the incidence of seizures in patients with FES, and the impact of seizures on outcomes over a 10-year period. METHODS: Using the National Inpatient Sample data set we identified adults (age 18 y old or above) with a diagnosis of FES (ICD-9 958.1) between 2005 and 2014, and categorized them according to the presence or absence of seizures. We excluded patients with a history of epilepsy or traumatic brain injury RESULTS: : Of the 66,227,531 discharges, we identified 1888 patients (0.003%) with FES of which 53% were male and mean age of 56 (±57.45). Seizure or epilepsy rate in patients with FES was 2.86% (1.69% with seizures and 1.16% with epilepsy), as compared with 3.6% in all hospitalized patients without FES. The Charlson Comorbidity Index for all FES patients was 2.38 (±5.28) and was similar for those with and without seizures. Hospital length of stay was higher in patients with FES and seizures versus those without seizures (14.59 vs. 10.82 d, P=0.09). No statistically significant difference in mortality was observed between the 2 groups. CONCLUSIONS: The rate of seizure and epilepsy in patients with FES is low when compared with rates in all hospitalized patients or in patients with other causes of acute neurological injury such as intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury. Further studies are needed to provide recommendations for antiepileptic medication use in FES.