PT  - JOURNAL ARTICLE
AU  - Melissa Myland
AU  - Brian Buysse
AU  - Wan Tsong
AU  - G Sarah Power
AU  - Douglas Nordli
AU  - Richard F M Chin
TI  - Seizure frequency, healthcare resource utilisation and mortality in childhood epilepsy: a retrospective cohort study using the THIN database
AID  - 10.1136/archdischild-2019-316910
DP  - 2019 Nov 01
TA  - Archives of Disease in Childhood
PG  - 1070--1076
VI  - 104
IP  - 11
4099  - http://adc.bmj.com/content/104/11/1070.short
4100  - http://adc.bmj.com/content/104/11/1070.full
SO  - Arch Dis Child2019 Nov 01; 104
AB  - Objective To understand the association of seizure frequency with healthcare resource utilisation (HCRU) and mortality in UK children with epilepsy (CWE).Design Retrospective cohort study.Setting Routinely collected data in primary care from The Health Improvement Network UK database.Patients CWE ≥1 and<18 years of age with a record of seizure frequency were included in mortality analyses from 2005 to 2015 and HCRU analyses from 2010 to 2015.Main outcome measures Frequency of HCRU contacts during the year following latest seizure frequency and mortality (descriptive and Cox proportional hazards regression) from first record of seizure frequency.Results Higher seizure frequency was related to increased HCRU utilisation and mortality. In negative binomial regression, each category increase in seizure frequency related to 11% more visits to general practitioners, 35% more inpatient admissions, 15% more outpatient visits and increased direct HCRU costs (24%). 11 patients died during 12 490 patient-years follow-up. The unadjusted HR of mortality per higher category of seizure frequency was 2.56 (95% CI: 1.52 to 4.31). Adjustment for age and number of prescribed anti-epileptic drugs at index attenuated this estimate to 2.11 (95% CI: 1.24 to 3.60).Conclusion Higher seizure frequency is associated with greater HCRU and mortality in CWE in the UK. Improvement in seizure control may potentially lead to better patient outcomes and reduced healthcare use.