Objective:

We aimed to assess for the existence of an untreated population of patients with post-traumatic epilepsy (PTE) by using a single hospital administrative database to analyze the traumatic brain injury (TBI) population for PTE rates and evidence of neurology follow-up.

Background:

In the U.S., there are approximately 2.5 million TBI cases yearly, with PTE occurring in an estimated 15% of cases. Pre-disposing risk factors for development of PTE include severe TBI and penetrating head injury. PTE patients are known to experience poor functional outcomes and increased negative social factors. We decided to investigate long-term follow-up, a subject not thoroughly studied in PTE patients.

Design/Methods:

A retrospective chart review with a 5-year timeframe was conducted using the administrative database of an urban Level 1 Trauma Center. Patients with ICD-10-CM codes associated with TBI were identified. Patients were assigned to a TBI with or without PTE group by presence of codes associated with PTE. An additional query was conducted for patients with ICD-10-CM R56.1 (post-traumatic seizures). Datapoints collected included risk factors for PTE and encounters with neurology. A univariate logistic regression model was used to identify factors associated with PTE and significant variables were tested in a multivariable analysis model.

Results:

A total of 1886 TBI patients were identified, with 178 (9.44%) classified as TBI with PTE. The most significant risk factor associated with PTE was severe brain injury, with an odds ratio of 2.955 (95% CI [2.062,4.236]; p<.0001). 19 of 178 patients (10.7%) visited neurology at least 6 months after TBI. In the ICD-10-CM R56.1 query, 101 of 158 patients (63.9%) visited neurology at any time.

Conclusions:

Our results suggest the presence of a significant population of patients with PTE and the need for better follow-up. This work can be used to guide future studies aimed at better understanding and improving the PTE treatment gap.