Abstract Details

Title Comparison of nationwide trends in 30-day readmission rates after laser interstitial thermal therapy (LITT) and open surgical procedures for refractory epilepsy (Nationwide Readmission database 2012-2018)

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S24 - Epilepsy/Clinical Neurophysiology (EEG): Clinical Epilepsy (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Background Surgery for medically refractory epilepsy (RE) is an underutilized treatment modality, despite its efficacy. LITT, which is minimally invasive, is increasingly being utilized for a variety of brain lesions and offers comparable seizure outcomes.

Objective Aim of this study was to report the national trends and outcomes after surgical procedures for RE with the advent of LITT.

Design/Methods Nationwide Readmission Database (2012-2018) was queried to identify all patients ≥18 years who were readmitted within 30 days after a hospital discharge for primary diagnosis of RE who underwent either open surgeries (lobectomy, partial lobectomy, and amygdalohippocampectomy) or LITT were included using ICD 9/10 procedure codes in primary field.

Results Among 205,966 patients with RE, 3.1% patients (n=7950) underwent either open surgical procedures (92.4%) or LITT (7.6%). Combined 30-day readmission rate for all surgical procedures was 9.2% (9.4% after Open surgery and 6.3% after LITT). Compared to LITT, patients with open surgery were associated with longer median length of stay (4 vs 1 days), higher cost of index (52190$ vs 36968$) hospitalization. During index hospitalization, Open surgical patients were associated with higher incidence of post-operative CNS infection (5.2% vs 3%), and disposition to facility (7.9% vs 2.4%). Majority of LITT procedures were elective (95.9%) and were performed at large-bed-size hospitals (88.3%). All LITT procedures were performed at teaching facilities and during weekdays. Compared to open surgery, LITT had higher incidence of uncontrolled epilepsy related readmission (47.8% vs 27.1%) and less incidence of post-operative infections (13% vs 26.5%).

Conclusions LITT is associated with a shorter LOS, a higher likelihood of being discharged home, lower readmission rate and lower index hospitalization charges compared to open procedures. LITT is a safe treatment modality in carefully selected patients with RE and careful management of postoperative seizures can further reduce healthcare burden in this patient population.

Authors/Disclosures
Varun Kumar, MD (Arrive Streeterville) PRESENTER	Dr. Kumar has nothing to disclose.
Mark Warman, MD	Dr. Warman has nothing to disclose.
Parisha Bhatia, MD	Dr. Bhatia has nothing to disclose.
Chirag N. Savani, MD (Tampa General Hospital)	No disclosure on file
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology)	Dr. Singh has nothing to disclose.
Alfred T. Frontera, Jr., MD (James A. Haley VA)	Dr. Frontera has nothing to disclose.
Selim R. Benbadis, MD, FAAN (University of South Florida)	Dr. Benbadis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stratus. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for SK Lifesciences. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Jazz. Dr. Benbadis has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eisai. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Neurelis. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Livanova. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Benbadis has received research support from Greenwich/Jazz. The institution of Dr. Benbadis has received research support from SK Lifesciences.