Patient-Reported Outcomes (PROs) in Acute Symptomatic Seizure (ASyS) Versus Patients With Established Epilepsy

Area of Science:

• Neurology
• Critical Care Medicine
• Patient-Reported Outcomes

Background:

• Acute symptomatic seizures (ASyS) are common in critically ill patients.
• The impact of ASyS on posthospitalization health outcomes compared to established epilepsy is not well understood.

Purpose of the Study:

• To compare posthospitalization self-reported health in patients with ASyS versus those with established epilepsy.
• To analyze the trajectory of patient-reported outcomes over one year following hospitalization.

Main Methods:

• Retrospective cohort study (2010-2018) using an institutional epilepsy database.
• Collected patient-reported outcome measures (PROMs) including seizure frequency, Liverpool Seizure Severity Scale (LSSS), Quality of Life in Epilepsy (QOLIE)-10, PHQ-9, and PROMIS-GH.
• Utilized mixed-effects models adjusted for age, sex, and race to assess score changes over one year.

Main Results:

• 15,311 established epilepsy patients and 317 ASyS patients were analyzed.
• ASyS patients were older, predominantly male, more often Black, and had worse baseline QOLIE-10, PROMIS-GH Physical Health, and LSSS Ictal scores.
• Adjusted analysis showed ASyS patients had 38% fewer seizures but worse QOLIE-10 scores; all PROMs improved over time except PROMIS-GH Mental Health.

Conclusions:

• Patients with ASyS reported fewer seizures but a worse epilepsy-specific quality of life compared to patients with established epilepsy.
• Patient-reported outcomes generally improved over the one-year follow-up period for both groups.
• Findings highlight distinct posthospitalization health profiles for ASyS and established epilepsy patients.