Literature DB >> 35002556

Trends and Costs Associated With the Diagnosis and Treatment of Infantile Spasms: A 10-Year Multicenter Retrospective Review.

Mindl M Weingarten1, Jon A Cokley2, Brady Moffett2, Shannon DiCarlo2, Sunita N Misra3.   

Abstract

OBJECTIVE: Early treatment of infantile spasms (IS) may be imperative for improvement of neurodevelopmental outcomes. Existing studies have led to inconclusive recommendations with variation in treatment. Our objective was to determine the national average cost, initial diagnostic workup, treatments, and hospital length of stay for patients with IS.
METHODS: This retrospective cohort study was designed to review data of patients < 2 years from 43 non-profit institutions. Data obtained included patient demographics, length of stay, admission cost, and treatments used from 2004 to 2014. Cost data were collected and adjusted to 2014 dollars, the year data were analyzed.
RESULTS: A total of 6183 patients met study criteria (n = 3382, 55% male). Three-quarters of patients (n = 4684, 76%) had an electroencephalogram, 56.4% had brain imaging (n = 3487), and 17% (n = 1050) underwent a lumbar puncture. Medication for IS was initiated during inpatient hospital stay in two-thirds of all patients (n = 4139, 67%). Most patients were initiated on corticotropin (n = 2066, 33%) or topiramate (n = 1804, 29%). Average length of stay was 5.8 days with an average adjusted cost of $18,348. Over time there was an 86.6% increase in cost from an average $12,534.54 (2004) to $23,391.20 (2014), a significant change (p < 0.01). This correlated with an increase in average length of stay.
CONCLUSIONS: Variability exists in diagnostic workup and pharmacotherapy initiated for IS, which may lead to differences in the cost of hospital stay. Further studies may help determine contributing factors to increased cost and improve health care utilization for IS patients. Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: mhelms@pediatricpharmacy.org 2022.

Entities:  

Keywords:  West syndrome; adrenocorticotropic hormone; epileptic spasms; epileptic syndrome; infantile spasms; pharmacoeconomics; vigabatrin

Year:  2021        PMID: 35002556      PMCID: PMC8717615          DOI: 10.5863/1551-6776-27.1.29

Source DB:  PubMed          Journal:  J Pediatr Pharmacol Ther        ISSN: 1551-6776


  52 in total

1.  The underlying etiology of infantile spasms (West syndrome): information from the United Kingdom Infantile Spasms Study (UKISS) on contemporary causes and their classification.

Authors:  John P Osborne; Andrew L Lux; Stuart W Edwards; Eleanor Hancock; Anthony L Johnson; Colin R Kennedy; Richard W Newton; Christopher M Verity; Finbar J K O'Callaghan
Journal:  Epilepsia       Date:  2010-08-17       Impact factor: 5.864

2.  H.p. Acthar gel and cosyntropin review: clinical and financial implications.

Authors:  Jacob Gettig; Joseph P Cummings; Karl Matuszewski
Journal:  P T       Date:  2009-05

3.  Cost-effectiveness of adrenocorticotropic hormone versus oral steroids for infantile spasms.

Authors:  Iván Sánchez Fernández; Marta Amengual-Gual; Marina Gaínza-Lein; Cristina Barcia Aguilar; Ann Marie Bergin; Christopher J Yuskaitis; Chellamani Harini
Journal:  Epilepsia       Date:  2021-01-08       Impact factor: 5.864

4.  Vigabatrin versus ACTH as first-line treatment for infantile spasms: a randomized, prospective study.

Authors:  F Vigevano; M R Cilio
Journal:  Epilepsia       Date:  1997-12       Impact factor: 5.864

Review 5.  Summary of recommendations for the management of infantile seizures: Task Force Report for the ILAE Commission of Pediatrics.

Authors:  Jo M Wilmshurst; William D Gaillard; Kollencheri Puthenveettil Vinayan; Tammy N Tsuchida; Perrine Plouin; Patrick Van Bogaert; Jaime Carrizosa; Maurizio Elia; Dana Craiu; Nebojsa J Jovic; Doug Nordli; Deborah Hirtz; Virginia Wong; Tracy Glauser; Eli M Mizrahi; J Helen Cross
Journal:  Epilepsia       Date:  2015-06-30       Impact factor: 5.864

6.  A comparative study of high-dose and low-dose ACTH therapy for West syndrome.

Authors:  S Yanagaki; H Oguni; K Hayashi; K Imai; M Funatuka; T Tanaka; M Yanagaki; M Osawa
Journal:  Brain Dev       Date:  1999-10       Impact factor: 1.961

Review 7.  West syndrome: etiological and prognostic aspects.

Authors:  K Watanabe
Journal:  Brain Dev       Date:  1998-01       Impact factor: 1.961

8.  Effect of price increase of adrenocorticotropic hormone on treatment practices of infantile spasms.

Authors:  Carter D Wray; Timothy A Benke
Journal:  Pediatr Neurol       Date:  2010-09       Impact factor: 3.372

9.  Clinical profile of infants with hypsarrhythmia.

Authors:  Wael Hayel Khreisat
Journal:  Acta Inform Med       Date:  2011-09

10.  Validating an Algorithm to Identify Patients With Infantile Spasms Using Medical Claims.

Authors:  Ling Wang; Shannon Yarosz; Hosain Aghamoosa; Zachary Grinspan; Anup D Patel
Journal:  J Child Neurol       Date:  2018-06-04       Impact factor: 1.987

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